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VETERINARY MEDICINE SERIES 

No. 14 

Edited by D. M. CAMPBELL 



SPECIAL 
EQUINE THERAPY 



MART'R/STEFFEN, V.S., M.D.C. 

Author of Special Veterinary Therapy, Special Cattle Therapy, 

Best Paying Prescriptions, The Itinerant Horse 

Physician, etc., etc. 



Published by 

AMERICAN VETERINARY PUBLISHING CO. 

CHICAGO 



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Copyright 1917 by 
Ameeican Veterinary Publishing Co. 



JUN 30 1917 

©CI,A467700 



PREFACE 

In this work special attention is given to diseases and 
conditions which are unnamed, atypical, or of infrequent 
occurrence. It is such conditions that are troublesome 
and difficult both of diagnosis and treatment. 

The discussions herein are entirely from the viewpoint 
of the general practitioner ; diagnosis and treatment are 
emphasized, while all quibbling over super-scientific de- 
tails are ignored. 

All conditions and diseases, as well as their treatments, 
are considered wholly from an American standpoint. 
Such diseases as occur only in foreign countries are not 
considered. 

Diseases of very common occurrence, such as the prac- 
titioner handles almost daily, are also omitted. 

The volume is intended to serve the busy practitioner 
chiefly as a reference work for diseases and conditions 
with which, because of their infrequent occurrence, he 
is not familiar, as well as an aid in the diagnosis and 
treatment of other more common, yet troublesome, 
diseases. 

M. R. S. 

1917. 



In every work regard the writer's end, 
Since none can compass more than they intend; 
And if the means he just, the conduct true, 
Applause, in spite of trivial faults, is due. 

— Pope. 



TABLE OF CONTENTS 

PAGE 

PAET I — ^Introduction. 

The Limitations of Veterinary Practice 7 

System in Medication 10 

PAET II — Miscellaneous and More or Less Baffling 
Affections. 

1. Ehinorrhagia 13 

2. Contagions Pustular Stomatitis 15 

3. Guttural Pouch Tympany 18 

4. Myxoid Degeneration of Facial Bones 21 

5. Acute Infectious Pharyngitis 24 

6. Senile Pharyngeal Paralysis 31 

7. Edema of the Glottis 33 

8. Choke 35 

9. Hygroma of the Withers 42 

10. Laminitis 45 

11. Spasm of the Diaphragm 48 

12. Melanosis 51 

13. Chronic Polyarthritis 54 

14. Osteoporosis 56 

15. Mange 59 

16. Epidrosis 60 

17. Internal Hemorrhage 61 

18. Pseudo-Hysteria of Unsexed Males 63 

19. Permanent Internal Hydrocephalus 65 

20. Meningism 67 

21. Vertigo of Young Horses 70 

22. Coughs 72 

23. Pneumonia 75 

24. Acute Yellow Atrophy of the Liver 83 

25. Jaundice 85 

26. Leukemia 87 

27. Diabetes Insipidus 88 

28. Diabetes Mellitus 90 

29. Lupinosis 92 

5 



6 CONTENTS 

PAGE 

30. Thrombotic Colic 95 

31. Diseases of tlie Heart 99 

32. Azoturia 101 

33. Transient Crural Paralysis 118 

34. Lymphangitis 120 

35. Epizootic Lymphangitis 124 

36. Foot Scab 126 

37. Foot Rot in Colts 127 

38. Umbilical Hernia 130 

39. Paralysis of the Cauda Equina 132 

40. Agalactia in Mares 134 

41. Strangles 137 

42. Influenza 141 

43. Infectious Cerebro-Spinal Meningitis 147 

44. Erysipelas 151 

45. Septicemia 153 

46. Malignant Edema 160 

47. Purpura Hemorrhagica 163 

48. Acute Infectious Dysentery 169 

49. Tetanus 173 

50. Anthrax 181 

51. Rabies 185 

52. Tuberculosis 189 

53. Dourine 190 

54. Glanders 194 

PART III— Poisonings 199 

1. Coal Oil Poisoning 200 

2. Carbolic Acid Poisoning 201 

3. Aconite Poisoning 202 

4. Cocaine Poisoning 202 

5. Arsenic Poisoning 203 

6. Mineral Acid Poisoning 204 

7. Gelsemium Poisoning 205 

8. Acute Lead Poisoning 205 

INDEX 209 



PAET I 
INTRODUCTION 



THE LIMITATIONS OF THE PRACTICE OF VET- 
ERINARY MEDICINE FROM A COMMER- 
CIAL STANDPOINT 

The practice of veterinary medicine is peculiar in 
the fact that in many instances the veterinarian 's great- 
est usefulness lies in the early recognition of an unfa- 
vorable termination of a given case. But by an unfavor- 
able, or an unsatisfactory termination we do not mean 
the death of the patient from the effects of the disease- 
In the practice of veterinary medicine the veterinarian 
must nearly always measure his results on a basis of 
dollars and cents. While there are many dangerous and 
grave pathological conditions which the veterinarian 
could succeed in bringing to an ultimate recovery, he is 
frequently forced to abandon treatment and recommend 
destruction of the horse. The time required to bring the 
case to cure, the loss of the animal's services during this 
time, and the veterinarian's and druggist's bill, would in 
many cases exceed the value of the horse several times 
over. 

The ability to foresee an unsatisfactory outcome such 
as this, as well as the exercise of good judgment in lim- 
iting the expense of useless treatment, is of especially 
great importance in a city practice. Many extraordinarily 
successful city practitioners owe their unusual success 

7 



8 SPECIAL EQUINE THERAPY 

to this ability as much as to their ability as practitioners 
of veterinary medicine and surgery. 

In a country practice, while the same money basis of 
case handling must be always borne in mind, it is not of 
quite so much importance. The country practitioner's 
clients usually have ample stable room and plenty of 
feed for their horses. Neither is the serviceableness of 
work horses on the farm computed at day wages, as is 
the case with most city horses. In addition to this, there 
usually remains the alternative of consigning the animal 
to procreative function should the patient be of the 
female sex. The latter alternative is the gateway to 
the ultimate recovery of many grave cases in a country 
practice, cases that in a city practice would inevitably 
end in the destruction of the horse. 

While it is of very great importance that the attend- 
ing veterinarian call a halt in the handling of cases of 
this sort, it is of no less importance to be patiently per- 
sistent in some cases that, although presenting a most 
discouraging clinical picture, are known to terminate in 
a manner that warrants the expenditure of a considerable 
amount of time and money. This is especially true in 
the handling of certain eases in young horses, horses that 
will yet "grow into money." 

An item that is worth considering along this same line 
of thought is that pertaining to the fee charged by the 
veterinarian when a difficult, protracted case terminates 
in death. While it may seem that the veterinarian's fee 
is not based upon the life or the death of the animal, but 
wholly upon the service rendered in connection with 
the case, it may be questioned whether this is entirely 
correct. 

Young graduates who are just beginning to establish 
themselves in practice in a community must give consid- 
erable thought to such matters. It does not help to in- 



INTRODUCTION 9 

crease the doctor's popularity if he adheres too strictly 
to an iron-bound schedule of fees in cases like those under 
discussion. The failure of beginners to give thought to 
these matters and to use good judgment is one of the 
commonest handicaps in the race with an older and more 
experienced competitor. 

The diseases and other pathological conditions that 
will be discussed in the following pages of this volume 
are nearly without exception cases in which the attend- 
ing veterinarian must make use of a goodly amount of 
judgment of this character. 

"While it is usually not so very difficult to foresee the 
termination of a given ease, it is nearly always quite a 
troublesome matter to so adjust the business relation 
between veterinarian and client that no friction will 
result. An agreeable relationship of a commercial char- 
acter can usually be maintained by the application of 
a degree of flexibility in the doctor's schedule of fees — 
an application that ultimately brings good returns. 



10 SPECIAL EQUINE THERAPY 

SYSTEM IN MEDICATION 

It may be appropriate to devote a few pages to the 
discussion of what might be termed medical exhibition. 
I mean by this the individual dosage in a particular 
case of any disease. I believe that most of our veterinary- 
doses are excessive. I also believe that most of our doses 
are unnecessary. With exceptional opportunities for 
becoming familiar with a much greater than usual num- 
ber of medicinal agents, I find that I am able to meet 
most ordinary pathological conditions almost without the 
use of drugs. 

When I do find it necessary to employ medicinal mat- 
ter I find that I get the best results from the use of doses 
that are in nearly every case much smaller than the ac- 
cepted standards. 

This is not because I have greater knowledge of the 
action of drugs. I believe it is wholly from the fact that 
I make better use of the natural assistance inherent in 
our patients. More clearly, I give my patients the op- 
portunity to benefit by this inherent assistance; I give 
them a chance. I have no ear for homeopathy ! But 
neither have I for the automatic gradation of doses, based 
on human medicine, still employed too largely by the 
veterinary profession. 

I have taken extraordinary steps along this line. I 
have had the good fortune to have been in a position in 
which I could put theory into practice, and I am sin- 
cerely satisfied that the average veterinarian does his 
medical cases but little real good. By far the majority 
of recoveries which he credits to his treatment are not 
the result of his treatment, but rather the result of his 
patient having had sufficient stamina to overcome not 
only the disease, but the injudicious dosage of drugs as 
well. Our patients differ markedly from the human pa- 



SYSTEM IN MEDICATION 11 

tient in the fact that, with very few exceptions, the dis- 
eases to which our patients are subject have a tendency 
to terminate in recovery; not because the diseases are 
more mild than those affecting human beings, but be- 
cause our patients are less vulnerable. Our patients, 
with an occasional canine exception, lead simple exist- 
ences. They do not consume either liquids or solids 
deleterious to their well-being; they do not become satu- 
rated with nicotine or other poisons. Their nervous sys- 
tems are not developed at the expense of their physical 
power. And, of greatest importance, is the fact that, 
while possessed of a brain, they have no highly developed 
mind. 

The resisting power against disease with which our 
patients are endowed frequently borders on the miracu- 
lous. 

The practitioner who, by cultivating his powers of 
observation of these characteristics, uses in his treatment 
of disease doses just large enough to assist this power 
will get results which will very frequently border on the 
miraculous. In this lies the answer to the question why 
bacterins accomplish what they do. In this lies the an- 
swer why iodid of potassium can work such wonders ; it 
is one of the few drugs that establishes its own limit of 
dosage by the production of iodism. 

We do not pay enough attention to the individual in 
veterinary practice. To most of us a horse is a horse. 
With hundreds of pounds of difference in size, we merely 
administer "a dose for a horse." We accept as doses 
for individual use what were only intended for general 
standards. 

But it is not only in the dosage that we are in error. 
It is just the same in the selection of a drug in a given 
case. Most of our treatments smack of heroics. Instead 
of gracefully bending a case to the accompaniment of 



12 SPECIAL EQUINE THERAPY 

natural efforts on the patients' part, we endeavor to 
"make or break" all too commonly. We select agents, 
the action of which is, frequently, too direct. And, 
again, all too frequently, our remedy, instead of attack- 
ing the disease, does its heaviest work upon tissues not 
in the least involved, or else upon tissues and organs al- 
ready bearing the brunt of the attack. Most of us can 
remember the old forms of treatment for acute indiges- 
tion. With a stomach already so full of ingesta and gas 
that it was nigh unto bursting, and frequently it did 
burst, we persisted in pouring in dose after dose. Many 
times several gallons of oil and other liquids have been 
added. Today we do just the opposite ; we use a stomach 
tube and remove the fermenting mass, and deaths from 
rupture of the stomach following an attack of acute in- 
digestion are today exceedingly rare. In dozens of other 
diseases we perform just as unreasonable (if not quite 
such evident) capers in the line of treatment. Instead 
of assisting the natural powers of the body (and in our 
patients these most assuredly deserve recognition), we 
make it doubly hard for them. 

The reader will note the simplicity of treatments rec- 
ommended in this volume. Adherence to these principles, 
and their adaptation to other conditions than those here 
discussed will prove a revelation to most practitioners 
who are unfamiliar with them. Every method of treat- 
ment named in the following pages has been thoroughly 
tested in actual practice and found reliable. 

No space has been devoted to any other purpose than 
the expounding of result-getting matter. It is presumed 
that the reader is fully conversant with the business 
end of the profession and that no admonition is required 
upon points relating entirely to the whims of a clientele. 



PART II 

MISCELLANEOUS AND MORE OR LESS 
BAFFLING AFFECTIONS 



RHINORRHAGIA 

A profuse flow of blood from the nose, and having its 
source in the vessels of the nose, is termed rhinorrhagia. 

The treatment of this condition is considered irrespect- 
ive of its cause, for the reason that the first concern in 
this condition is always the checking of the hemorrhage. 
When a case of rhinorrhagia is presented for our atten- 
tion, we are not particularly concerned about the direct 
cause of the bleeding; we attend to this, if necessary, 
after the hemorrhage is under control. 

In veterinary practice alarming hemorrhages from 
the nose are rare; most of these are limited to a harm- 
less epistaxsis which usually ceases spontaneously, "When, 
however, rhinorrhagia does occur in horses the condition 
is especially serious for the reason that these animals vio- 
lently resist the veterinarian's efforts, and also because 
of the anatomical arrangement of the turbinated bones. 

Severe hemorrhage in the nose must be differentiated 
from pulmonary hemorrhage. Blood coming from the 
lungs appears foamy and produces fits of coughing dur- 
ing its emission. In severe nasal hemorrhage the phar- 
ynx may fill with blood and also cause some cough. If 
this creates doubt as to the source of the hemorrhage, 
the trachea is to be auscultated. If the hemorrhage is 

13 



14 SPECIAL EQUINE THERAPY 

from the lungs, rales and gurgling sounds are heard in 
the trachea. If it is from vessels in the nose these sounds 
are not present, unless the hemorrhage has occurred in 
company with an acute pulmonary disease. The diagno- 
sis must then hinge on the foamy appearance of the 
blood. 

Treatment of Bhinorrhagia. When nasal hemorrhage 
is severe enough to require treatment in the horse, prompt 
and active remedial efforts need to be resorted to. The 
patient should, if possible, be backed into a single stall 
and cross-tied as for dental work. By means of a long 
dressing forceps the nostril, or if blood comes from both 
sides, both nostrils, are quite snugly packed with gauze. 
To facilitate the removal of the gauze after the hemor- 
rhage is checked, it should be in one piece, and should 
have been previously saturated with sweet oil. The sweet 
oil prevents the adhesion of the gauze to the bleeding 
spots, and also delays putrefaction in the event that the 
gauze must remain in place for a considerable length of 
time. As a rule it is safe to remove the gauze twenty- 
four hours after the hemorrhage has been stopped. 

"Whenever it is necessary to pack both nostrils, trache- 
otomy must first be performed. Tracheotomy alone will 
at times check a nasal hemorrhage, by making snorting 
and blowing of the nose impossible. This gives an op- 
portunity for clots to form and to remain in place. 

If the hemorrhage is not thought of such gravity as to 
require packing of the nasal cavities, an attempt may be 
made to check it by irrigating the nasal canal with a solu- 
tion of supra-renal extract, or by the spraying of solution 
of supra-renal extract into the nasal cavity with an atom- 
izer having a long nozzle. 

Usually it saves time and trouble to proceed at once 
with the gauze packing. Irrigating, spraying or swab- 
bing usually brings on fits of sneezing or snorting and 



CONTAGIOUS PUSTULAR STOMATITIS 15 

coughing, which only have the effect of aggravating the 
hemorrhage and complicating matters. Most horses v^ill 
violently resent the irrigating and spraying, while the 
gauze packing is calmly submitted to in most cases. 

CONTAGIOUS PUSTULAR STOMATITIS 

Contagious pustular stomatitis of horses is an acute 
febrile condition whose local manifestations occur chiefly 
on the oral mucous membranes. While this disease has 
all the characteristics of an infectious and contagious 
disease, there is some question about its being a strictly 
infectious ailment. The infecting agent is not univer- 
sally recognized, although some investigators have iso- 
lated certain strains of micro-organisms, which may, 
however, be accounted for by a secondary or mixed in- 
fection. Other authors consider the disease a manifes- 
tation of horse pox, while others, again, attribute the 
infection to a common cause such as may occur from 
contaminated feed. There is some ground for the latter 
assumption because the disease has a tendency to remain 
enzootic and to affect nearly all the members of a stable 
in a routine manner. 

The specificity of the condition is, on the other hand, 
fairly well substantiated by the fact that human beings 
frequently become infected; characteristic pustular der- 
matitis develops on the hands. Veterinary surgeons are 
occasionally infected thus while examining the mouth, 
and the disease has been known to take a very serious 
course in several cases of veterinarians so affected. (Dr. 
Jas. Eobertson, Professor of Veterinary Dentistry at 
Chicago Veterinary College, narrowly escaped death 
from the effects of an infection of this type in 1900.) The 
period of inoculation in the horse is from six days to two 
weeks. 



16 SPECIAL EQUINE THERAPY 

Symptoms. The disease begins with a moderate fever, 
accompanied by mild depression. There is anorexia, but 
frequently polydipsia. When the opportunity is given 
to drink, the animal likes to prolong the act, by playing 
with the lips, deeply immersing the muzzle, and so forth. 
Some salivation may be noted. Examination of the mu- 
cous membrane of the mouth shows in the early stages 
reddened areas. The mouth is hot and sensitive. The 
reddened areas later "run together," and are then the 
seat of small, hard elevations. They appear in various 
sizes, from that of a mustard seed to the size of buck-shot. 
These hardened elevations or nodes appear in "crops" 
day after day for several days. The earlier ones go over 
into vesicles, break and discharge either a clear serum or 
pus. The later ones do the same, successively, until the 
disease has run its course. The broken down vesicles 
and pustules rapidly fill with granulations and heal over 
smoothly in a few days. An occasional extraordinarily 
large vesicle or pustule, or when several of them coalesce, 
may leave a deep ulcer which heals more slowly and 
leaves a ' ' pearly ' ' scar. In some outbreaks of contagious 
pustular stomatitis the pustules also form on the skin 
of the lips, and some cases have come to our attention in 
which the sides of the neck and pectoral region were 
involved. 

The first cases in an outbreak are as a rule the most 
virulent, while towards the end the cases are usually 
very mild. The duration of the disease, from onset of 
the fever to complete healing of all pustules and vesicles, 
is from one to two weeks, depending upon the severity 
of the attack and upon the care which the animal re- 
ceives. The fever subsides after the third day. Some 
deaths have been reported. Fatal cases are extremely 
rare, and are no doubt due to septic infection of a sec- 
ondary character when they do occur. C 



CONTAGIOUS PUSTULAR STOMATITIS 17 

The diagnosis hinges on the course pursued by the dis- 
ease and its contagiousness. First, fever and general 
depression; second, reddened areas in the mouth; third, 
vesicles, pustules; fourth, rupture of the vesicles. The 
appearance of other cases in the same stable always fol- 
lows. The vesicles and pustules are peculiar in their 
small size and the fact that they appear first on the mu- 
cous membrane. Later, in some cases, they may appear 
on the skin. 

Treatment. Antiseptic, astringent mouth washes 
should be used. A saturated solution of the sulpho-car- 
bolates compound is fine, for the reason that it can be 
used liberally and does no harm when some of it hap- 
pens to be swallowed. Ulcers which occasionally form 
are to be painted several times daily with equal parts 
tincture of iodin and tincture of benzoin. On general 
principles a dose of mixed bacterins is indicated. The 
animal should have sloppy feed and constant access to 
fresh water. The animals are not serviceable for at least 
one week. An outbreak of contagious pustular stomatitis 
can be considerably shortened in stables or a community 
if the early cases are promptly isolated and strictly quar- 
antined. 



18 SPECIAL EQUINE THERAPY 

TYMPANY OF THE GUTTURAL POUCHES 

To one who has never seen this abnormality it gives 
rise to thoughts of apprehension. Cases of distension of 
the guttural pouches with air appear to be serious to 
the veterinarian who has had no experience with them. 
As a matter of fact, it is usually a very benign and de- 
cidedly transient affection. 

We meet with this condition most frequently, almost 
always, in mares that have recently given birth to a foal 
and that have been turned out to pasture after having 
been confined to the stable for a long period of time, and 
in debilitated colts of from one to three years of age 
when turned out to pasture in the early spring when 
they must graze nearly all the time to get sufficient nour- 
ishment. 

A few hours seems to be all the time required for the 
condition to become fully established, although as a gen- 
eral thing the condition is first noticed towards evening 
of the first day that the animal has been turned out. 

It is then seen that the region over the parotid glands, 
the laryngeal region, and sometimes the space between 
the rami of the inferior maxilla are immensely swollen. 
If a halter has been left on the mare while she has been 
at pasture parts of it are deeply imbedded and buried in 
the swelling. When the swelling is palpated it is found 
to be drum-like and very tense. When force is applied 
to one side by pressing with the fiat hand over the parotid 
region the opposite side bulges out in proportion. If a 
finger is pressed firmly into the body of the swelling and 
the pressure is suddenly released by quickly withdrawing 
the finger great resilience is noted, and no pit remains. 

Near the borders of the swelling there is edema in some 
cases, no doubt due to interference with the circulation 
from direct pressure. 



TYMPANY 19 

In cases in which the distension is exceedingly great, 
there may be a slight degree of dyspnea. In cases show- 
ing only moderate distension there is no dyspnea. Even 
in cases of the most marked type the animal does not, as 
a rule, exhibit any signs of distress or indisposition. The 
symptoms are apparently limited to the tumefied condi- 
tion in the region. The diagnosis must be made from: 

First, the history of the case; mare with foal, turned 
on grass after a long period of idleness in the stable; or 
debilitated colt as before mentioned. 

Second, the nature of the swelling; pneumatic under 
palpation, and painless. 

Third, the absence of other symptoms of disease. The 
temperature may be raised slightly, but not much. The 
pulse, if taken, must be taken at some extremity, such as 
from the coccygeal artery. It will be slightly accelerated. 

Treatment. In very marked cases in which there is 
much dyspnea, immediate relief may be attempted by 
the exertion of a firm, steady pressure with the flat hands 
over both sides of the swelling. 

Should this fail to give relief it need be no cause for 
anxiety. The dyspnea will subside markedly after the 
lapse of a few hours if the patient is at once placed in a 
single stall and tied short at the halter, so that the head 
may not be lowered. But by no means should the head 
be raised above a normal standing-level. 

If it is requested that something be done further than 
this, an oily liniment may be prescribed with which the 
tumefied area may be gently massaged. 

In all cases, almost without exception, coming to the 
attention of the writer, the swelling had completely dis- 
appeared in less than twelve hours. No recurrences have 
come in the cases noted. 

If the condition escapes detection on the first day, or 
if the animal is allowed to remain in the pasture after 



20 SPECIAL EQUINE THERAPY 

the swelling has been noticed, a marked edema affecting 
the entire head may result. When this has occurred the 
treatment consists of confinement in a single stall with 
the head raised. The easiest manner in which to keep 
the head raised in some of these cases is by means of a 
bridle and back-pad, using an overhead check to check 
the animal high. This is usually sufficient and should 
be maintained several hours. Downward massage, lightly 
done, is helpful. Cold packs may also be of benefit. Two 
or three doses of digitalis improve the circulation and 
hasten the disappearance of the swelling due to inter- 
ference with the circulation. 



MYXOID DEGENERATION 21 

MYXOID DEGENERATION OF BONES 

Not many cases of a myxoid osseous degeneration are 
on record in veterinary science Whether this is due to 
the fact that it is a rare affection, or whether veterina- 
rians have failed to report the cases out of their prac- 
tices, I do not know. I have been able to find but very 
little literature on the subject. One case that came up 
in my practice a short time ago I reported in the Ameri- 
can Journal of Veterinary Medicine. As the description 
of the case is quite fully given in this report I reproduce 
it here, as follows : 

''Not many eases of myxoid degeneration of the bones 
of the skull in horses are on record. Apparently it is 
a very rare pathological condition. Cases which have 
been reported were mostly in young horses and sucking 
colts ; now and then the condition has been known to occur 
in mature animals. 

' ' The ease which I am about to record is that of a grey 
gelding about seven or eight years old. He is a fair 
specimen of the express type and in good condition, 
weighing about 1,250 pounds. He was raised by the man 
who owns him now and was supposed to be a 'whistler' 
or 'roarer' since colthood. 

' ' This roaring was not typical and, until the evidence 
of the myxoid degeneration developed, it could not be 
satisfactorily diagnosed. Now that the true condition 
has shown itself the roaring, according to other records 
of such cases, is explained. 

' ' On looking up these cases I found that in nearly every 
instance the horse was either affected with roaring, snor- 
ing or had some other form of respiratory impediment 
which was puzzling and which could not be satisfactorily 
diagnosed until the appearance of signs of the myxoid 
degeneration. 



22 SPECIAL EQUINE THERAPY 

"The case in this grey gelding was brought to us for 
treatment because of a 'bunch' on his forehead. 

' ' According to the owner 's statement it had been form- 
ing for several months, being about the size of a hazel 
nut when first noticed. It had now attained the size of 
a large hen egg and had about the form of an egg, the 
apex pointing straight outward, like a horn. 

' ' No abrasion could be seen ; the skin over it was per- 
fect. 

' ' The location of the ' bunch ' was exactly over the fron- 
tal sinus, a little to the left of the median line. To the 
examining finger it felt very tense, almost hard, and 
pressure with the finger over it evidently caused consid- 
erable pain, evidenced by jerking the head and attempts 
at rearing up. A cyst was diagnosed ; no details as to the 
nature of the cyst were gone into. 

"With a twitch on the nose an exploring trocar was 
inserted. Instead of pus (which was really what we 
expected to find), there came a flow of rusty-colored 
liquid which spurted outward to a distance of six or 
eight feet. 

"As the contents flowed out the apex of the 'bunch' 
caved in and it could now be plainly felt with the exam- 
ining fingers that the frontal bone at the base of the 
bunch had disappeared or become absorbed. The skin 
could be pushed into the sinus like an inverted glove 
finger. 

"The diameter of the hole in the frontal bone was ir- 
regular, varying from one inch at the narrow point to 
more than two inches at the widest. The edges were very 
smooth and seemed to have a thickened margin. 

"When most of the fluid had been drawn off the area 
was painted with iodin and the horse sent home, with 
instructions to bring him in again in three or four days. 
This gave us time to look up the handling of the condition. 



MYXOID DEGENERATION 23 

"When the horse was brought in again the 'bunch' was 
just as big as it had been before we tapped it and the 
owner stated that it had filled up a few hours after he 
took him home. 

"As we had 'brushed up' on the condition and its 
treatment by this time we recommended incision of the 
bunch, thorough curettement of the sinus and of the 
edges of the frontal bone. This was refused. 

"We then prescribed painting the enlargement and 
a considerable area around it with iodin, and iodid of 
potassium internally. 

"After two weeks of this treatment the enlargement 
has gone down considerably, but an interesting change 
has occurred. There is now a discharge from both nos- 
trils of a fluid the same color and consistency as that re- 
moved with the trocar. Evidently the process has pro- 
gressed and the sinus is now draining itself. 

' ' The gelding shows no ill effects in any other manner 
and works every day. The owner has now consented to 
submit him for operation at a later date. If he keeps his 
promise we will report results. ' ' 

The owner did not keep his promise, and the case was 
lost sight of. 

A few practitioners have reported similar cases in 
younger horses. Curative treatment recommended con- 
sists of complete removal of all the affected bone by 
means of trephining, sawing and curetting. This is fol- 
lowed by irrigation with suitable antiseptics for about 
six weeks. 

The cause of this disease is unknown. In the early 
stages, before the swelling is fluctuating in character, 
the condition must be differentiated from osteoma, and 
in some cases from catarrh of the frontal sinus which 
has produced a prominent bulging of the frontal and 
facial bones. The insertion of an exploratory trocar re- 



24 SPECIAL EQUINE THERAPY 

suiting in the evacuation of the characteristic rusty-col- 
ored fluid, establishes the diagnosis of myxoid degenera- 
tion. 

There is no doubt that, under proper treatment, the 
bone which has disappeared would be regenerated, al- 
though the effect of this regeneration of bone might fall 
short of expectations. 



ACUTE INFECTIOUS PHARYNGITIS 

In taking up the discussion of this subject I would 
begin with the statement that I am aware that some 
authors of works on equine medicine believe this to be a 
localized manifestation of influenza. A form of acute 
pharyngitis does occur during some outbreaks of influ- 
enza. I am positive, however, that the authors in ques- 
tion are in error when they classify all forms of acute 
pharyngitis of an infectious and transmissible character 
under the head of influenza. We have in the United 
States a form of acute infectious, contagious pharyngitis 
in horses that occurs as a disease per se, unaccompanied 
by lesions which could bring it recognition as a manifes- 
tation of influenza. 

The disease under discussion here occurs in an enzootic 
form as a rule, although during some seasons it has as- 
sumed almost epizootic force. It affects both young and 
old horses, without regard to condition or individual en- 
vironment, and runs a typical and almost exact course 
in all cases. This is its first feature of differentiation 
from acute pharyngitis resulting from a localized influ- 
enza infection. Hardly two cases of the latter form 
appear similarly, while the disease which we have under 
discussion runs in every instance a typical, characteristic 
course. 



INFECTIOUS PHARYNGITIS 25 

Symptoms. The disease appears almost as a subacute 
affection. For one or two days before it becomes fully 
established the animal has a cough. This cough is not 
heard, however, except during or after drinking water 
and eating grain. It may be so mild as to escape the 
attention of the owner or attendant. In from one to 
three days after the cough has set in the horse has some 
difficulty with his deglutitory acts. While drinking, 
some of the water returns through the nose; the animal 
stops drinking after every few swallows and experiences 
a paroxysm of coughing and spasmodic gulping. In the 
beginning of the disease the amount of water that re- 
turns through the nose is slight; later it appears as 
though literally pumped through the nasal chambers with 
each act of deglutition. 

In another day, or at most two, after the inability to 
swallow water normally, the horse finds it impossible to 
swallow grain. "While the appetite does not seem to be 
entirely lacking, in fact remaining good throughout the 
attack, in many cases the grain is refused. At times the 
animal attempts to eat oats, but after the first mouthful 
or two the attempt is again given up. Nearly all of these 
subjects eat hay throughout the course of the disease. 
All boluses of hay are not swallowed, however. The 
manger is soon strewn with boluses that have been mas- 
ticated but again ejected on account of inability to 
swallow. 

Here we have another good mark for differentiating 
this disease from such cases of pharyngitis as occur from 
an influenza infection. In pharyngitis resulting from 
influenza the horse shows genuine anorexia ; he does not 
eat because he has no appetite, no desire to eat. In the 
disease we are discussing the horse would eat if he could: 
his appetite is not gone. He makes repeated daily at- 
tempts, but does not succeed in swallowing well on ac- 



26 SPECIAL EQUINE THERAPY 

count of the pain and interference with the proper action 
of the muscles concerned in the act of deglutition. 

When the dysphagia has become fully established, at 
the end of from one to three days, there appears a fullness 
in the parotid, pharyngeal and laryngeal region. The 
swelling is smooth and lies rather below and under the 
parotid glands, pushing these upward and outward. In 
some cases abscesses form in this swelling. 

The temperature may not be raised more than two or 
three degrees; occasionally a case will show temperature 
as high as 106 degrees F., but this is not common. Cases 
in which the temperature is much elevated are usually 
those that later have abscess formation in the swelling 
described. Despite quite high temperature and marked 
local swelling, soreness on palpation in the swollen re- 
gion, and marked indications of a severe disturbance 
in the affected parts, the horse does not appear very 
sick. Depression is absent and animals remain bright. 
Here we have another point against attributing these 
cases to localization of influenza infection. In the latter 
there is marked depression, drowsiness, and other evi- 
dence of genuine sickness. 

Acute infectious pharyngitis requires from one to three 
weeks to run its course. If no abscess formation occurs 
two weeks suffice to bring even fully developed cases to 
a satisfactory termination. The mortality is very low, 
practically nil, under treatment. 

The danger of transmission is nominal. In some in- 
stances all the horses in a stable become affected; in 
others only a part of them, and in some instances a single 
animal. This is not altogether explained by the fact 
that the infecting organism is lacking in virulence, but 
rather by the fact that one attack seems to confer a per- 
manent immunity. Animals in the stable already im- 
mune from the effects of earlier attacks, will not develop 



INFECTIOUS PHARYNGITIS 27 

the disease. In exceptionally severe cases, showing great 
tumefaction in the region, considerable dyspnea may 
occur. Hardly ever does it become so serious as to re- 
quire the performance of tracheotomy. 

There is no discharge from the nose in most cases 
until the dysphagia is fully established. It is then of 
a muco-purulent character, and not very copious. This 
would indicate that the discharge is chiefly the result of 
an irritation of the Schneiderian membranes as a result 
of contact with water and food particles that flow 
through the nasal chambers. Cases that develop an 
abscess in the pharynx have a liberal purulent nasal 
discharge. On account of the inability to take suificient 
nourishment the affected animals lose considerable 
weight. The patients maintain a standing position 
throughout the course of this disease. 

I wish to call especial attention to what I have said 
about the order in which the ingested matter is rejected 
by the pharynx in this disease, namely, 

1. Water. 

2. Grain. 

3. Hay. 

This is always the order of sequence in this disease; 
and did we have no other single mark by which to differ- 
entiate this disease from other forms of pharyngitis, we 
would be able to recognize it thereby. To me this is also 
positive proof, in the absence of satisfactory bacterio- 
logical evidence, that this disease is not in any way allied 
to influenza. It is evidence that the dysphagia is not so 
much the result of an active inflammatory lesion in the 
pharynx at first, but more probably the result of a sec- 
ondary trophic disturbance. Were the dysphagia the 
result of a highly inflamed, painful state of the pharyn- 
geal mucosa and surrounding tissues, we have every rea- 
son to believe that the order of rejection would be re- 



28 SPECIAL EQUINE THERAPY 

versed; we would expect to have the patient retain the 
power to swallow water rather than hay. 

Treatment. Those animals that have the disease in a 
mild form are treated with no especial regard for the 
specificity of the affection. A good "stiff" liniment is 
rubbed into the throat several times a day. Apply the 
liniment over the parotid region, over the larynx, and 
between the rami of the lower jaw, A pail full of clean 
drinking water should be kept constantly in the manger 
where the horse can reach it without effort. The water 
may be impregnated with an astringent such as dilute 
sulphuric acid, chlorate of potassium, or ordinary mag- 
nesium sulphate. Fluid extracts of nux vomica and 
gentian may be given in small amounts with a dose 
syringe several times a day, for their tonic effect. 

The feed should consist of semi-liquid slops made of 
ground oats and bran. Affected animals should not be 
put to work until they have been able to eat and swallow 
normally for several days. In those animals with a more 
severe form of the disease the treatment must be some- 
what more arduous. In such a case, a good mustard plas- 
ter should be applied to the pharyngeal region; if the 
first one does not "take hold" sufficiently, put on an- 
other. When the mustard has ceased to act and has thor- 
oughly dried, smear the entire region freely with vase- 
line and bandage over this, using plenty of cotton under 
the bandage. 

Every case of this severe type of the disease should be 
given a full dose of mixed bacterins to forestall abscess 
formation. 

For internal treatment, the best, both for its local 
effect on the mucous membrane of the pharynx as well 
as for remote effect, that I have found, is beechwood 
creosote in glycerin. The dose of creosote here should 
be about five drops, using about two drams of pure glye- 



INFECTIOUS PHARYNGITIS 29 

erin in which to suspend it. This is then given every 
three or four hours with a dose syringe. Keep this creo- 
sote treatment up until .a,l improvement is seen, after 
which it should be continued another day or two. Follow 
with general tonics. 

The feeding and watering instructions that were given 
for mild cases should be followed in all forms. Abscesses 
are to be opened when the conditions are favorable, and 
treated as they would be treated in any other region. 

If a case should prove indifferent or unusually stub- 
born under this line of treatment, stop everything and 
give three or four large doses of potassium iodid, say 
two drams, every three hours until three doses have been 
given. Then begin again with the creosote treatment. 

When tracheotomy is necessary on account of serious 
dyspnea, perform tracheotomy as ordinarily done. 

Cases of acute infectious pharyngitis occurring in 
stables, the horses of which are not known to be immune, 
should be isolated and handled in every way as though 
affected with a contagious disease. 

Fullness in the pharyngeal region may remain in 
those animals in which the disease has been complicated 
by the formation of abscesses. This may be dispersed 
by the use of iodids internally and massage with oily 
preparations of iodin locally. 

In some eases a tenacious cough remains for weeks 
after all other signs of the disease have disappeared. 
This cough does not always yield to the same treatment. 
Some cases respond rapidly to ordinary cough mixtures ; 
some are cured by a few medicinal doses of potassium 
dichromate, while an occasional ease may prove stub- 
born under any and all forms of handling. In a few 
instances there has remained a permanent dyspnea of 
a mild character. 

During the course of an attack of this disease, I have 



30 SPECIAL EQUINE THERAPY 

seen no other complication than abscess formation. De- 
glutition pneumonia, which might be an expected com- 
plication, I have never seen occur in company with acute 
infectious pharyngitis. Neither has the patient, in any 
ease, required feeding by artificial means. 

In old horses acute infectious pharyngitis may have to 
be differentiated from senile paralysis of the pharynx. 
A confusion is only possible, and even then not very 
probable, in the early stages. In cases of senile paralysis 
the history is always to the effect that the trouble has 
been coming on very slowly. For months the horse has 
shown signs of a deglutition impediment of an obscure 
character. 

Neither is there any marked degree of pyrexia. In- 
stead of fullness and tenderness in the pharyngeal region, 
there is rather a lean throat, and soreness is absent. 



PHARYNGEAL PARALYSIS 31 

SENILE PHARYNGEAL PARALYSIS 

A paralysis affecting; the apparatus concerned in deg- 
lutition is occasionally seen in horses as a disease of old 
age. This paralysis is not one that makes its appearance 
very precipitately, but its appearance usually means the 
end of usefulness in the animal. Recovery is very rare. 

The first evidence of the approach of a senile paralysis 
of the pharynx is seen in "quidding"; the attendant now 
and then discovers a few "quids" or boluses of masti- 
cated hay in the animal's manger. The usual effect of 
this discovery is a visit to the veterinarian for the pur- 
pose of having the animal's teeth examined. The teeth 
are given whatever treatment the attending veterinarian 
may choose, but the animal persists in ' ' quidding. ' ' The 
condition slowly grows worse. Soon the animal gets poor 
in flesh, salivation is marked, and a slight nasal discharge 
is seen. Still later the horse finds it a difficult matter to 
swallow enough feed to sustain life ; even water is imbibed 
with difficulty. In some cases esophageal spasm, result- 
ing in choke, is repeatedly present. All cases have a 
cough. 

From the outset of the first symptoms to the end in 
death from inanition, from four or five months to two 
years may elapse. A few cases improve spontaneously, 
and occasionally recovery follows proper treatment. 

Strychnin in small doses repeated several times daily 
for a few weeks is useful. Fowler's solution of arsenic 
repeated in small doses is followed by improvement in 
some cases. 

Cases which resist either of these agents may improve 
rapidly under a course of potassium iodid. Local treat- 
ment, such as light blisters, iodin paintings and massage, 
are of use in some instances. Other eases resist all efforts 
toward improvement or cure. 



32 SPECIAL EQUINE THERAPY 

The diagnosis is made in old horses by observing a 
gradually increasing dysphagia, unaccompanied by fever 
or local evidences of pharyngeal disease, such as swelling 
or soreness. The condition may possibly be confused 
with the dysphagia occurring in some cases of spinal or 
cerebro-spinal meningitis, as well as with the dysphagia 
of meningism. The comparatively rapid development 
of other signs common to these diseases promptly pre- 
cludes the existence of senile paralysis of the pharynx. 

Gases of pharyngeal paralysis resulting from injuries 
are ruled out by the rapidity with which they become 
established, as well as by usual evidences of trauma. 
Cases of dysphagia, due to stenosis in old horses, are 
usually accompanied by snoring or whistling. 

Senile pharyngeal paralysis is due to sclerotic proc- 
esses in the brain and spinal cord in all instances. 



EDEMA OF THE GLOTTIS 33 

EDEMA OF THE GLOTTIS 

"When the submucous tissues of the glottis become infil- 
trated with inflammatory exudate or with congestive 
fluids of other character, the condition is one of grave 
import. While edema of the glottis is, in many cases, 
merely a complication of laryngeal or pharyngeal inflam- 
mations, it does occur at times as a distinct and separate 
clinical phenomenon. No doubt, occasional instances of 
sudden death, attributed to other causes in the absence of 
positive evidence, are due to this condition. 

Symptoms. The clinical picture in edema of the glottis 
is that of asphyxiation. The horse finds it impossible to 
inhale ; exhalation is not interfered with. There is great 
excitement, the animal frequently ' ' paws the air, ' ' throws 
itself against the sides of its stall; the urine dribbles 
away, perspiration sets in. In other cases the horse 
stands quietly enough, breathing wheezily and with great 
effort. The animal usually resents palpation in the 
laryngeal region, and pressure on the larynx increases 
the dyspnea. Edema of the glottis always develops very 
suddenly and progresses rapidly to a fatal end by asphyx- 
iation in many cases. From the beginning of the first 
symptoms to the termination of the attack in death may 
require not more than half an hour. 

Treatment. If asphyxiation is near, evidenced by 
staggering, opening of the mouth in the effort to inhale, 
cyanotic membranes, tracheotomy alone can save the life 
of the horse. No time should then be spent in preparing 
the operative area and the operation should not be de- 
layed because no trachea tube is at hand. In the latter 
emergency the tracheal incision can be held open by 
means of artery forceps or sutures until a tube can be 
procured or a makeshift improvised. The edema may 
subside within a few hours, or it may remain for several 



34 SPECIAL EQUINE THERAPY 

days. The tube can be removed as soon as normal inhala- 
tion is possible. 

Cases which are not so near asphyxiation can usually 
be handled satisfactorily with Dr. Quitman's guaiacol 
treatment. One dram of the drug is shaken up with an 
ounce or two of water and given with a dose syringe. 
Repeat in an hour, if it is necessary. As the guaiacol 
does not mix very well with the water, it should be added 
to the water at the time it is to be given, drawn into the 
syringe and violently agitated by shaking the syringe. It 
is then rapidly squirted into the mouth and pharynx. 
The effect of this drug in this condition frequently bor- 
ders on the marvelous. Local or external applications 
in the form of counter-irritants of a mild type may be 
used in conjunction with the guaiacol treatment. The 
application of ice may also be tried. 

If the relief afforded by this form of treatment does 
not become promptly evident, perform tracheotomy with- 
out further delay. 



CHOKE 35 



CHOKE 



Choke is the name applied in veterinary practice to tliat 
condition resulting from the permanent lodgement of 
food or other matter in the esophagus. In horses choke 
is always caused by the arrest of either hay or grain in 
some portion of the esophagus. Choke from solid bodies, 
vegetables, for instance, can almost be said never to occur 
in horses. The pharynx of horses seems to positively 
refuse passage to any matter that has not gone through 
the process of mastication quite thoroughly. 

Choke in horses is classified into cervical and thoracic 
forms. "When the offending matter finds lodgement in 
that portion of the esophagus anterior to the thorax, it is 
termed cervical choke. When the lodgement is in the 
thoracic portion of the esophagus, it is termed thoracic 
choke. The classification is only of value for purposes 
of treatment. 

Blocking of the esophagus with food in the horse is 
possible under two distinct pathological types. The most 
common type, which includes probably 98 per cent of all 
eases, is that in which the condition is a purely functional 
disorder. Because of a peculiar disarrangement in the 
nerve impulse controlling the esophageal musculature, a 
spasmodic contraction arrests the progress of a bolus of 
food on its way to the stomach. A less frequent, in fact, a 
very rare form, is one in which a structural defect exists 
in the esophagus in the form of a dilatation, or jabot. 
Dilatations of the esophagus vary from a very slight en- 
largement in the diameter from atonic muscular areas 
to veritable saculations of considerable portions of the 
tube. 

Choke in horses is always a grave condition, requiring 
the exercise of much good judgment on the part of the 
attending veterinarian. In most cases the condition, from 



36 SPECIAL EQUINE THERAPY 

a pathological standpoint, is nothing more than a func- 
tional disturbance. This does not reduce the gravity of 
the condition, however, from the practitioner's stand- 
point. The seriousness of the case lies mostly in the 
damage inflicted on the patient by the handling that the 
case is usually subjected to before the veterinarian's 
arrival. 

The prognosis in cases of spasmodic choke is always 
favorable when the patient has not been the subject of 
malpractice, such as the entrance of whips, traces, broom- 
sticks and similar objects into the esophagus, at the hands 
of laymen or empirics. The prognosis becomes unfavor- 
able in direct proportion to the amount of injudicious 
interference that has been applied. This is the point that 
the veterinarian must, by all means, keep in mind in 
beginning the handling of a case of choke in the horse. 
Place the responsibility where it belongs. Understanding 
the condition fully, as you do, have no regard for the 
feelings of your client if he has been guilty of any form 
of malpractice in connection with the ease in hand. It 
is a proved fact, substantiated by abundant clinical evi- 
dence, that injudicious meddling with a case of choke 
nearly always results disastrously. The attending veter- 
inarian should have no scruples against so informing the 
client that has so committed himself. Undertake the 
handling of such cases advisedly; promise nothing, and 
expect nothing. 

Cases of choke in the horse that come into the veter- 
inarian's hands uncontaminated by ignorant practice 
can be given a favorable prognosis in almost all in- 
stances. The exceptions are those few cases in which the 
condition is due to a structural change, a dilatation or 
jabot. 

To unconcernedly take in charge a case of choke, with 
no regard for the handling the case has received before 



CHOKE 37 

the doctor was called in, shows lack of experience in 
these conditions. 

In my practice I do not hesitate to inform the client 
who has meddled with a case of choke that he must abide 
by the consequences. I place all the responsibility con- 
nected with the case on his shoulders. I take the case 
for what it is worth ; I do what ought to be done. But 
I offer no encouragement. 

On the other hand, I view with extreme optimism all 
cases that come to me ' ' first-hand. " I do not hesitate to 
make light of the case. I try in every manner to place 
my client's mind at ease and to relieve him of all worry 
about the patient's state. My chief object in doing this 
lies in the way of obtaining a free hand in the handling 
of the case. As a graduate veterinarian I realize that 
non-interference is worth more in cases of choke than 
injudicious treatment. If I succeed in placing my client 
in a frame of mind compatible with this knowledge, I have 
made a big stride towards a satisfactory termination of 
the case. 

Symptoms. (Spasmodic Choke.) The symptoms of 
choke in the spasmodic form are more acute than in that 
form caused by a dilatation of the esophagus. The ani- 
mal stops eating suddenly, backs away from its feed, and 
shows signs of restlessness. When the animal attempts 
to swallow, a gurgling sound is heard over the esophagus, 
and the cervical region goes through an attack of mus- 
cular cramps or convulsions. The muscles in the region 
seem to contract en masse, while the esophageal canal 
stands out in bold relief. If the obstruction is in the 
cervical portion of the tube, it is usually possible to 
detect it during one of the cramps. There is then an 
added prominence or a greater thickness that can be 
seen over the obstruction. The majority of spasmodic 
chokes are in the cervical region. 



38 SPECIAL EQUINE THERAPY 

Cases of choke resulting because of a dilatation in some 
portion of the esophageal tube appear less precipitately. 
In some instances it requires the lapse of several days 
before a complete ' ' choke ' ' is established, the animal hav- 
ing continued to add to the obstruction by eating at 
times. (In spasmodic choke the patient refuses all food, 
as a rule. ) When enough food has collected in the dilated 
portion of the esophagus to block the passage the animal 
begins to show symptoms. These symptoms, however, 
are not violent. There is now no inclination to eat. There 
may be a slight degree of retching, accompanied by mild 
muscular contractions in the cervical region. 

If the choke is located in the cervical portion of the 
esophagus, it can usually be detected by palpation. In 
choke resulting from esophageal dilatation the mass of 
food is considerable; enough so that it can be both seen 
and felt in the form of a bulging area in the esophageal 
canal. When choke from dilatation has existed for sev- 
eral days food is regurgitated, the nostrils are smeared 
with it, and an offensive odor emanates from the oral and 
nasal cavities. In some cases the animal continues to eat 
even then. At the end of variable periods of time the 
patient succumbs either from an attack of inspiration 
pneumonia or from gangrenous processes involving the 
gullet. Choke from dilatation may, under some condi- 
tions, be only a partial choke. 

Prognosis. The prognosis is favorable in all cases of 
spasmodic choke not complicated by injuries sustained 
at the hands of persons endeavoring to correct the condi- 
tion by means of probangs or other heroic treatment. 
The prognois is grave when such treatment has been 
administered. 

The prognosis in cases of choke resulting from dilata- 
tion of the esophagus is always doubtful. Eventually all 
of these cases terminate fatally. A few attacks are sur- 



CHOKE 39 

vived, but ultimately death occurs during one of them. 
Dilatation choke is recurrent. Choke of the spasmodic 
variety is not. Choke in all forms is more serious when 
in the thoracic portion of the esophagus than when it is 
in the cervical portion. 

Points of value in diagnosis and of import from the 
side of prognosis are : 

1. In spasmodic chokes (which includes nearly 98 per 
cent of all cases) the symptoms are acute, urgent. In 
dilatation choke the symptoms are not so impressive. 

2. In spasmodic choke the point at which the food has 
lodged can only be detected during one of the muscular 
cramps, in the cervical form. In dilatation choke the 
fullness over the obstructed portion of the esophagus can 
be seen or felt at all times, in the cervical form. In 
thoracic forms it is never possible to make this observa- 
tion. 

3. History of repeated attacks of choke in the same ani- 
mal is almost positive evidence that dilatation exists, 
which will eventually cause the animal's death. Spas- 
modic chokes rarely recur. 

4. In dilatation choke the horse may continue to swal- 
low some food even after the choke is fully established. 
In the spasmodic form feed is refused. 

Treatment. Spasmodic Form. The treatment of this 
form of choke is based on the knowledge that we possess 
of its pathology. Recognizing this form of choke as a 
simple functional disturbance, we treat the case accord- 
ingly. With the use of agents having such tendencies 
we endeavor to overcome the spasm in the parts involved. 
We know that as soon as this spasm is relieved the bolus 
of food that is in its grasp will pass on. Therefore, we 
use no probang or other mechanical appliance in the 
treatment of this form of choke. One grain of pilocarpin 
hydrochlorid, hypodermatically, will relieve most spas- 



40 SPECIAL EQUINE THERAPY 

modic chokes almost as quickly as the effects of the injec- 
tion become evident. If no relief is evident at the end 
of three or four hours the injection may be repeated. All 
feed must be withheld. "Water is allowed. Sloppy food 
should be given the patient for a few feeds after an 
attack of choke. Cases that prove unusually obstinate 
should be given several days' time before it is decided to 
resort to surgical interference. In the meantime, an in- 
jection, hypodermatically, of a grain of apomorphin may 
be successful in relieving the choke. 

Important points in the treatment of a case of spas- 
modic choke are : 

1. Complete, absolute abstinence from food. 

2. Access to water must be allowed. 

3. Patience. Give the case time. There is no cause for 
worry if all feed is withheld. 

4. Forbid all forms of mechanical interference. 
Cases that do not yield to the above treatment within 

forty-eight hours are almost positive to be dilatation 
chokes. Judicious use of the probang, or direct surgical 
aid is then indicated. Cases in which the obstruction is 
in the thoracic portion of the esophagus, and that do not 
yield to medication must be patiently subjected to re- 
peated entrances of the probang. The introduction of an 
ordinary stomach tube and the irrigation of the mass 
with water through this tube will, in many instances, 
yield good results if patiently and delicately carried out. 
The use of force is not permitted, especially in cases due 
to dilatation of the esophagus. The esophageal wall is 
very thin in some of these cases and is therefore easily 
torn by even ordinary pressure. In the cervical por- 
tion Merillat's operation is the operation of choice. 

Horses that are known to be the subjects of an esopha- 
geal dilatation should be fed on semi-liquid feed at all 
times. Even this, however, does not prevent occasional 



CHOKE 41 

obstruction in cases that have a saculation of the esopha- 
gus. Dilatation that is diagnosed in the cervical portion 
of the esophagus would deserve operative interference 
aiming at the restoration of the normal calibre of the tube. 
Resection of the atonic area and coaptation of the healthy 
margins under aseptic precautions might prove suc- 
cessful. 

It may occur in rare instances that the veterinarian 
is called to treat a case of dilatation choke in the cervical 
region that has been in existence for a week or longer, 
and that has been subjected to injury of various kinds 
at the hands of laymen or others. In such eases there is 
usually a diffuse, rather firm swelling in and around the 
jugular groove. There are traces of food particles in the 
nostril and an odorous, creamy or syrupy discharge issues 
from the nostril. The history which is given with the case 
usually helps to make the diagnosis quite sure. 

Treatment, to be of avail in these cases, must be some- 
what heroic. The large swelling must be incised and food 
particles removed from the tissues if the esophagus has 
ruptured or necrosed. If the esophageal tube is yet sound 
the incision must be carried in to reach the esophagus, lay 
it open and remove the collection of food or other matter. 
After preparing the edges of the esophageal wall appro- 
priately, this is to be sutured. The patient is to be sup- 
ported with nutritious rectal injections until healing oc- 
curs. The results from this treatment are usually sur- 
prisingly satisfactory. 



42 SPECIAL EQUINE THERAPY 

HYGROMA OF THE WITHERS 

While hygroma of the withers is essentially a condition 
for surgical consideration, it is given a place in these 
pages for the reason that the early symptoms are amen- 
able to medical treatment. Hygroma of the withers has 
not been given much attention in veterinary literature. 
The reason for this is the fact that usually it is not diag- 
nosed in its true character. Another possible reason why 
this condition has received but slight attention at the 
hands of writers is that the veterinary practitioner does 
not usually meet with the condition in its original and 
early form. 

The mark of distinction between a hygroma of the 
withers and fistula of the withers is pus, or the absence 
of it. Hygroma of the withers occurs most commonly in 
young horses. The condition is, almost invariably, the 
result of bruising from ill-fitting collars, and from blows, 
contusions, or pressure. It makes its appearance in the 
form of a smoothly rounded tumefaction on top of the 
withers. In some cases it is apparent only on one side 
of the median line. This tumefaction varies in size from 
that of a small orange to the size of a football. On pal- 
pation the tumefaction is of varying degrees of tenseness, 
having the feeling of a "wind puff. " There is at first 
considerable local heat and slight tenderness under pres- 
sure. If not treated, gradual enlargement follows. Hard- 
ness develops in the margins of the swelling, pus forma- 
tion follows, abscess and fistulous openings develop later. 

In rare cases the condition becomes stationary, or dis- 
appears spontaneously. A fully developed hygroma, 
sometimes of great size, frequently appears within so 
short a period of time as twenty-four hours. The forma- 
tion of pus usually requires from three weeks to as many 
months. 



HYGROMA 43 

The contents of an hygroma of the withers are, in the 
beginning, either a bloody serum or an amber-colored, 
sticky fluid. Later there is found in this fluid variable 
quantities of flat, or discoid, masses. These resemble 
adipose tissue, are quite firm and from one-eighth to two 
inches in their greatest diameters. Pus formation is 
probably the result of the degeneration of these masses. 

Hygroma is differentiated from the tumefaction of 
fistula : 

1. By the history of the case. Hygroma usually de- 
velops very rapidly. 

2. By the ''wind-puff-like" tenseness of the swelling. 
Treatment. Hygroma of the withers in existence not 

longer than three or four days can be treated successfully 
with the use of prolonged hot or cold baths and astrin- 
gent, cooling lotions. The animal must be kept as quiet 
as possible while under treatment. Work or exercise 
makes the treatment of no avail. The baths may be 
either hot or cold and should be given at least twenty 
minutes out of each hour of the day. Several days of 
such bathing or fomenting, in conjunction with lotions 
of lead acetate, are in many cases sufficient to cause the 
dispersion of the swellings. The treatment is then fin- 
ished with iodin paintings twice daily for a few days. 
Cases that do not yield to this treatment, or those in 
which the tumefaction is only dispersed in part, must 
be treated in a surgical manner. 

The swellings are incised at their most prominent 
points, making a good, free incision, thus allowing the 
escape of fluid and discoids. The cavity is then irri- 
gated with an antiseptic solution and packed with gauze 
saturated with equal parts of oil of turpentine and lin- 
seed oil. This packing is allowed to remain for twenty- 
four hours, at the end of which time it is removed and 
the wound receives no treatment further than that every 



44 SPECIAL EQUINE THERAPY 

three or four days the cavity is irrigated with an antisep- 
tic solution of mild strength. Healing requires from two 
to four weeks. The horse can do light work during this 
time. 

It is not always necessary to incise the tumefaction on 
both sides of the withers. In very many of these cases 
all fluid and solids can be satisfactorily evacuated by 
incising one side only. In selecting the site for lancing, 
choose the side on which the swelling runs the farthest 
anteriorly. It is futile to attempt a cure in cases that 
have not yielded to fomentations by the use of an aspirat- 
ing needle or a trocar. While the fluid portion of the 
contents of the swelling can be drawn off in this manner, 
the solidified matter in the form of flattened disks re- 
mains. Within a few hours after the fluid has been 
drawn off, the regeneration of a similar, or even greater, 
amount takes place. If surgical intervention is indi- 
cated, nothing but free incision will prove satisfactory. 



LAMINITIS 45 

LAMINITIS 

Although laminitis is not a rare disease by any means, 
a little space devoted to a discussion of its treatment is 
appropriate here. The symptoms require no discussion 
in a treatise such as this. There does not seem to be a 
treatment for laminitis which can be said to be standard. 
While in some respects all forms of treatment for this 
disease are similar, yet every veterinary practitioner has 
some hobby that he indulges in, in the treatment of this 
disease. 

A form of treatment that has many followers is the 
adrenalin treatment. Here we have a form of treatment 
that really gives most remarkable results and that has a 
good foundation to stand on from a pathological and 
from a therapeutic sense. When used early in the attack, 
this treatment can be relied upon to shorten the course of 
the disease and to prevent disagreeable sequelae. A one to 
one thousand adrenalin chlorid solution is injected sub- 
cutaneously at various points in the coronary region. 
Some practitioners make the injection into the meta- 
carpal artery. This treatment, however, is only of value 
in the very early stages of laminitis. 

A treatment that gives uniformly satisfactory results 
with very reasonable promptness is the following : With 
a rasp thin out the horn in the coronary region as much 
as it will stand. The thinned area should go completely 
around the hoof and should extend downward toward 
the sole at least two inches. The horse does not offer any 
resistance to this rasping, despite the painful state of the 
feet. The shoes, if in place, are to be left in place ; I can 
imagine no exhibition of poorer judgment than that 
which the veterinarian shows when he insists on remov- 
ing the shoes from a laminitis patient. When the rasping 
off of as much horn as possible has been completed, this 



46 SPECIAL EQUINE THERAPY 

thinned area is literally soaked with pure tincture of 
iodin. It is to be painted on with a small brush, going 
over the area again and again, until the horn refuses to 
absorb any more of it. This means at least an ounce to 
each foot, and the application is to be repeated every 
twelve hours in a similar manner. Unless the case is 
more than ordinarily severe, two or three of these appli- 
cations will free the animal from all acute pain. The 
temperature comes to normal and the patient resumes a 
normal condition more rapidly than with any other treat- 
ment. The only improvement that I could suggest in this 
treatment would be to rasp down the entire wall, from 
ground surface to coronet, and then soak the feet in a 
tub of tincture of iodin. If I ever meet with a case of 
laminitis in a horse whose value would justify such a pro- 
ceeding, I shall try it. I believe that the effect would be 
marvelous. 

I use in every case of laminitis a daily cathartic dose of 
arecolin. Where this is impractical I use an aloes ball. 
In addition to this, every one of my laminitis patients gets 
a moderate dose of sulpho-carbolates compound three 
times a day for two or three days. With such treatment 
I do not find it a rare thing to see many of my cases ready 
for work in a week. 

When, for any reason, the rasping and iodin applica- 
tions can not be made, I resort to water. Hot water con- 
stantly applied often gives marvelous results. After 
wrapping the feet thickly with burlap, I see to it that 
some one soaks the burlap every Jiour with hot water. 
This is the only practical and a very humane method of 
water cure. To resort to the use of the soaking tub is 
unpardonable in this disease. 

Encourage the patient to assume the recumbent posi- 
tion by providing it with a deeply bedded box stall. In- 
struct the attendants to make it possible for the subject 



LAMINITIS 47 

to eat and drink while down; do anything reasonable to 
keep the patient off its feet. 

Although in laminitis we usually see very marked con- 
stitutional disturbance, the greatest effort, therapeutic- 
ally, is to be applied locally. And, for fine and complete 
healing, nothing is of such great importance as that por- 
tion of the nursing which encourages the recumbent 
position. From any point of view — pathologic, therapeu- 
tic, humane — one could, with full justification, force the 
recumbent position on the patient by the use of appro- 
priate restraint. 

Only in parturient laminitis must we add something to 
the treatment of this disease that is of greater importance, 
namely, liberal irrigations of the uterus. Aside from 
this the treatment of cases of parturient laminitis does not 
differ, and it is the only form of laminitis in which the 
treatment given aims directly at the cause. 



48 SPECIAL EQUINE THERAPY 

SPASM OF THE DIAPHRAGM 

This pathological condition is commonly termed 
"thumps." Some writers have alluded to it under the 
title of palpitation of the heart. The condition, from 
its pathological side, is not entirely clear. Most authors 
have, however, adopted the designation of diaphragmatic 
spasm, and content themselves with giving clinical proof 
that cardiac palpitation only occurs eoineidentally with 
the spasmodic contractions of the diaphragm. No doubt, 
there is a close connection between the two conditions. 
It has been a rather difficult matter in the past, however, 
to trace this connection. 

For all purposes of a practical nature it is sufficient 
that we understand that there occurs in these eases a 
pathological state which is, no doubt, due to a trophic 
nerve disturbance of some sort, and that the symptoms 
which we see as a result of this disturbance are, in the 
main, the effect of spasmodic contractions of the dia- 
phragm. We must accept this view if we would have our 
treatment of the condition conform to at least a semblance 
of scientific handling. 

' ' Thumps, ' ' or diaphragmatic spasm, is seen most com- 
monly in driving horses. Since the advent of the automo- 
bile, it has been forced into that class of diseases usually 
termed "rare," because of the fact that the class of horses 
which was most frequently affected is now decidedly in 
the minority. Heavy horses performing slow and method- 
ical work are hardly ever affected. Causative factors in 
the development of diaphragmatic spasm are over-exer- 
tion, especially during hot weather, heat, great excitement 
in nervous animals, and occasionally debilitating infec- 
tious diseases. 

The mortality rate is low, but the affection is important 
from a clinical standpoint because of the fact that the 



SPASM OF THE DIAPHRAGM 49 

practitioner is occasionally embarrassed in the presence 
of cases that prove stubborn under treatment, and because 
death does occur in some cases quite unexpectedly. Al- 
though recovery is the rule in this disease, the practi- 
tioner must be reserved in his prognosis. The clinical 
picture of a case of diaphragmatic spasm is a grave one 
in the eyes of the client. For the practitioner the case 
has no terrors, because he knows that most of these cases 
recover in from two hours to as many days. Now and 
then one dies, however, after the attending veterinarian 
has in all sincerity assured the client that the patient 
was in no danger of losing its life. And, usually, 
not only is the patient lost in these cases; the client 
is "lost," too. A safe rule on this point is to "view with 
suspicion" all cases of this affection that show no 
improvement within a few hours after treatment is 
begun. 

Symptoms. The most prominent symptoms in 
"thumps" is the thump. It is a thumping sound, usu- 
ally heard in company with, or immediately after, the 
heart beat. The sound can be heard plainly at quite a 
distance from the horse. The animal is much distressed 
and uneasy, the respiratory movements are accelerated, 
and with each ' ' thump ' ' the entire body moves in a jerky 
manner. 

The condition must be differentiated from an acute 
exacerbation of heaves. This can be done by carefully 
noting that the abdominal muscles in the flank region 
remain rounded, lacking the expiratory flatness charac- 
teristic of that act in heaves. If further confirmation is 
desired, a rectal examination can be made. In a case 
due to spasm of the diaphragm the contractions of the 
latter can be plainly felt along the borders of the last 
ribs, and these contractions will be found to coincide 
with the thumping sounds. 



50 SPECIAL EQUINE THERAPY 

Treatment. Morphin in full doses. From four to eight 
grains are given hypodermatically. If the diagnosis is 
correct, the treatment should show marked improvement 
within an hour. Cases occurring during hot weather 
from over-driving should be given cold shower-baths. All 
eases should have fresh air, should not be moved unneces- 
sarily, and should have constant attendance until almost 
completely relieved. 



MELANOSIS 51 

MELANOSIS 

Pathologists tell us that melanosis is a form of cancer. 
The tumors or nodules presented in this condition are 
said to contain pigment. The disease affects white and 
grey horses exclusively, appearing in the form of black 
nodes or buttons in the region of the anus, the under side 
of the tail, the sheath and penis, the eyelids, the lips, and 
at times in the skin on various other parts of the body. 
These nodes make their appearance at from the sixth to 
the tenth year of the animal's life. They increase in size 
slowly, but attain great dimensions, relatively, in very 
old horses. In the anal region they are frequently seen 
in clusters, occasionally in such numbers and of such 
size that the anal opening is displaced or hidden. In 
other parts of the body these tumors do not attain great 
size nor appear in such great numbers as they do in the 
anal region. 

The disease is, without question, hereditary. The get 
of a certain Percheron horse in this state, most of which 
were grey, are almost without exception affected with 
melanosis. I have treated five or six of these horses, 
and every one of them has from ten to thirty melanotic 
tumors. 

Only rarely does melanosis cause serious, or even trou- 
blesome, disturbances. In the anal region a melanotic 
node may suppurate or break down, producing a mild 
periproctitis. The discharge from melanotic tumors is 
at first a tarry, black paste. Later, ordinary pus mixed 
with bloody streaks appears. In some instances the de- 
velopment of a melanotic growth in the rectum or above 
the rectum in the sacral region may attain such size that 
it interferes with the fecal evacuations, either from direct 
blocking of the rectal canal, or from pain produced dur- 
ing the act of defecation. 



52 SPECIAL EQUINE THERAPY 

When melanosis affects an eyelid it must be differenti- 
ated from botryomycotie nodes, I have seen the two 
conditions affect an eyelid simultaneously. 

Melanotic growths in the sheath may prevent normal 
protrusion and retraction of the penis, resulting at times 
in a severe paraphimosis. 

Obscure cases of lameness in aged white horses that 
have melanosis may occasionally be attributed to pres- 
sure from a melanotic tumor on a nerve trunk in the 
parenchyma of a muscle in the affected limb. 

Traumatism in the immediate vicinity of a melanotic 
tumor nearly always results in serious consequences. 
Either the growth of the tumor is greatly stimulated 
thereby, so that a previously passive nodule becomes a 
rapidly growing, malignant tumor, or the wound itself 
assumes a vicious and stubborn character. Apparently 
the tissues surrounding such tumors are already sub- 
normal in vitality and resisting power. 

Melanosis in horses under ten years of age is usually 
passive. After the tenth year a passive melanoma in any 
part of the anatomy may become active. This should be 
considered in examining grey or white horses for sound- 
ness. A thorough examination for soundness in grey or 
white horses must always include examination of the 
rectum, with the object of detecting the presence of mela- 
notic growths in this canal. Their presence in, or sur- 
rounding parts of, the rectum constitutes an unsoundness 
in horses of any age. Some cases of rectal and anal 
fistula have their origin in a degenerated melanoma. On 
account of the hereditary nature of melanosis, the breed- 
ing of horses affected should be discouraged. 

Treatment. None while passive. When an isolated, 
single tumor becomes active in a region where a thorough 
enucleation is possible, it should be dissected out and the 
bed of the growth thoroughly cauterized. Simple dis- 



MELANOSIS 53 

section, without subsequent cauterization of the bed of 
the tumor, usually means a recurrence within a very short 
time. The secondary tumor is more active than the pri- 
mary one whenever a recurrence takes place. 

When a melanotic tumor becomes active in a region 
where a thorough dissection would be out of the ques- 
tion, the treatment can, of course, be only of a palliative 
nature. What this would be depends upon the location of 
the tumor and the extent to which it is hindering the 
function of the parts involved. 

While an active melanotic tumor is a grave condition in 
any part of the anatomy the attending veterinarian must 
never be pessimistic in giving a prognosis. In many 
instances these growths suddenly degenerate, discharge 
their contents, and a spontaneous cure results. This is 
especially true of these tumors in the anal region, and 
also when they develop within the rectum. A rectal 
examination should be the rule in all grey horses suffer- 
ing from colicky pains which cannot be clearly attributed 
to acute indigestion. Impaction just anterior to the rec- 
tum will frequently be found as the result of a melanoma 
involving the rectum or its surroundings. 

Melanosis affecting internal organs, such as the spleen, 
the liver, or other important organs, the heart at times, 
is not considered in this chapter because the symptoms 
produced do not vary from other malignant processes 
in these parts. The diagnosis is only made on autopsy. 
The treatment, even were an ante-mortem diagnosis made, 
would no doubt be futile. 

It is well to bear in mind, however, that obscure abdom- 
inal and thoracic affections, especially those of a sub-acute 
or chronic nature, in white or grey horses may be the 
result of melano-sarcoma in the organ suspected. 



54 SPECIAL EQUINE THERAPY 

CHRONIC POLYARTHRITIS 

Chronic inflammatory processes involving more than 
one articulation at the same time occur with fair fre- 
quency in horses. The condition is most often seen in 
horses past eight years of age, but younger horses are 
not entirely exempt. The etiology is not always the same, 
and in many instances this cannot be ascertained. By far 
the greatest number of these eases are the result of acute 
polyarthritis that developed at an earlier period of the 
animal's existence as sequelag to infectious diseases. In- 
fluenza, complicated strangles, pneumonia and pleurisy 
can be named as examples of predisposing affections. 
Some cases are, no doubt, due to a rheumatic diathesis, 
and are precipitated as the result of unhygienic sur- 
roundings, insufficient nutriment, and excessive work. 
The process is always non-suppurative, and is character- 
ized by a tendency towards malformation by the develop- 
ment of osseous changes, ligamentous and tendinous 
thickenings, and subsequent muscular atrophy. 

There are in this condition periodic axacerbations of 
lameness. Between these periods the horse is merely 
"sore." This "soreness" is peculiar in the fact that it 
disappears to a great extent, temporarily, with exercise. 
The changes in the joints, consisting of enlargement 
chiefly, begin to appear at the end of several months. 
With their appearance comes permanent lameness. Sev- 
eral months, at times a year, later wasting of the mus- 
cular frame in the affected limbs begins. The horse event- 
ually becomes "out of condition" generally, tires easily, 
refuses its feed after strenuous exercise or work, and 
finally is wholly unserviceable. In this stage most of 
these horses rarely lie down; when they do at times 
assume the recumbent position, they require some assist- 
ance in getting up. 



CHRONIC POLYARTHRITIS 55 

In the early stages, during the exacerbations of lame- 
ness, there is a slight rise in temperature. The diagnosis 
must exclude osteoporosis more than anything else. This 
is done by noting that the bony enlargement is confined 
wholly to the articulations, while in cases of osteoporosis 
the shafts of long bones, the flat bones, and the axial skel- 
eton generally, are involved. The entire course of chronic 
polyarthritis in horses requires several years to exhaust 
itself. The prognosis is invariably unfavorable. 

Treatment. In the early stages I have seen some good 
results from treatment aimed at the supposedly infec- 
tious character of the trouble, such as bacterin therapy 
with strepto-bacterins and staphylo-bacterins, and the 
administration of such remedies as salol, hexamethyl- 
enamin, and arsenic. Locally, active counter-irritants are 
employed. When marked changes have occurred in and 
around several articulations, not much remains to be 
done. 

Relief from lameness can be obtained for short periods 
of time in the latter cases by the administration of a 
mixture containing potassium iodid, phytolacca and col- 
chicum seed three times daily for a week or ten days. The 
enlarged and deformed articulations are to be massaged 
with oily preparations of iodin, or with mild mercurial 
ointments. 

The use of the actual cautery with the object of cor- 
recting the joint lesions and overcoming existing lameness 
is in these cases insupportable. 

The joints most commonly affected are the pastern, the 
ankle, the hock, the stifle, and the carpus. The elbow 
and shoulder joints are rarely involved. In a few cases 
I have even seen involvement of the tempero-maxillary 
articulation. 

From the good results derived in the early stages of 
some cases with the use of bacterins, it is fair to assume 



56 SPECIAL EQUINE THERAPY 

that most cases could be brought to a satisfactory termi- 
nation in the early stages if an autogenous bacterin were 
used. The results should be much better with autogenous 
bacterins than I have been able to get from the use of 
stock bacterins, 

OSTEOPOROSIS 

This is the American term for that form of osteo- 
malacia which affects horses in this country. It is what 
might quite properly be termed a sectional disease. In 
certain parts of the United States it is a very common 
disease, while in other sections hardly any cases are seen. 
The disease is supposed to be due to a serious lack of lime 
salts in the feed. At any rate, there is a very decided defi- 
ciency of mineral matter in the osseous tissue of animals 
affected with the disease. Recently the disease has been 
classed as an infectious disease. No satisfactory proof 
of such an etiology has yet been given, and the clinical 
manifestations do not in any manner support it. 

Osteoporosis is a chronic disease, choosing mature or 
aged animals for its subjects more frequently than young 
animals. Its course covers periods of time varying from 
a few months to several years. The prognosis is in every 
instance unfavorable. 

Symptoms. Osteoporosis makes its appearance insid- 
iously. Once the changes in the bone are recognized, the 
disease has already established itself quite fully. This is 
probably the chief reason why the treatment is unsatis- 
factory. The early symptoms are rather obscure ; by the 
time symptoms of sufficient prominence to make a diag- 
nosis possible are manifest, the disease has already done 
so much damage that there is little chance for restoring 
the health of the animal. Even in regions where the dis- 
ease is common most cases are not recognized until struc- 
tural changes have occurred in the skeleton, so insidious 



OSTEOPOROSIS 57 

is its approach. A common early symptom is obscure 
lameness. In regions where osteoporosis is of frequent 
occurrence this disease should be suspected in every 
instance in which an obscure lameness occurs, especially 
if in addition to the lameness there is a history of capri- 
cious appetite, lack of endurance, a tendency to perspire 
easily and a tendency toward leanness. 

Another symptom that occurs quite early in the course 
of this disease and which is quite reliable for purposes of 
early diagnosis is ' ' cracking ' ' of the joints. This ' ' crack- 
ing " is a sound that is very similar to a loud snapping of 
the fingers. It is heard with the first movements that 
the horse makes after he has been standing at rest for 
some time, and also at times when a sudden, quick turn 
is made by the animal. 

As the disease progresses the horse becomes unthrifty. 
His frame assumes an abnormal setting, most noticeable 
in a decrease in the obliquity of the pelvis. If the dis- 
ease is active in the bones of the limbs, these seem to 
increase in thickness, "buck-shins" develop, and the 
shafts of all the long bones become more rounded and 
increase in diameter. The bones involved in the disease 
process are easily fractured, and it is not uncommon for 
a fracture to occur while the animal is going through 
ordinary or normal movements. In other cases tendons 
pull loose from their insertions, ligaments are torn loose, 
and similar complications are met with frequently. 

When the disease affects the bones of the skull we see 
what is usually termed ''big head." The facial bones 
seem to puff out, giving the face a full appearance. As 
a result of changes in the facial and nasal bones there 
may be obstruction of the lachrymal duct ; narrowing of 
the nares and involvement of the turbinates may produce 
difficult breathing. The rami of the inferior maxilla are 
rounded and thickened. The molars become loose, so 



58 SPECIAL EQUINE THERAPY 

that mastication is imperfect, if not entirely impossible. 
We remember the case of a Shetland pony in which the 
course of the disease covered nearly four years; every 
year during this time one or more molars dropped out or 
were extracted. At the end of the fourth year not a tooth 
remained. When we last heard of this animal it was 
being kept alive on gruel. This is one characteristic of 
osteoporosis when it affects chiefly the bones of the skull, 
namely, that it frequently confines its ravages to these 
bones alone. The animals may, in such cases, live for 
3'ears, showing no other manifestation of the disease 
except the so-called "big head." 

Cases of osteoporosis presenting symptoms indicating 
general involvement of the osseous elements either sloAvly 
go on to death from inanition and exhaustion, or they 
come to an end from such complications as fractures, rup- 
tured tendons, and so forth. In some instances the dis- 
ease seems to become checked suddenly, remaining sta- 
tionary for years, and then suddenly becoming active 
again. 

Treatment. 'When the characteristic changes have oc- 
curred in the bones treatment is useless. If the diagnosis 
is made early the addition of lime salts to the feed, or the 
feeding of foodstuffs obtained from regions where the 
disease does not exist, will frequently stop the progress 
of the affection. 



MANGE 59 



MANGE 



Mange, or scabies, or scab, in horses is usually of the 
sarcoptic form. It is a disease affecting the skin and hair, 
and at times has a general devitalizing effect upon the 
subject. "While the disease is contagious, it also occurs 
sporadically. 

Symptoms. The disease begins with itching, as a result 
of which the horse rubs the infected parts against any 
convenient object. The parts first infected are usually 
the head and neck, shoulders and withers. Later the 
entire skin may be involved. Following the itching stage 
there appear numerous pimples or nodules of small size, 
which later burst and form scabs. The hair in the region 
comes out in tufts or patches, so that in a well-marked 
case considerable areas of the skin become hairless. When 
the disease is generalized and has existed for a long time 
the patient becomes emaciated and unthrifty. 

Treatment. Affected horses should have isolated stalls, 
individual brushes, curry-combs, and harness. So that 
treatment may be most effectual, the animal should be 
clipped first. The affected area should be thoroughly 
scoured with soap and warm water, so that all scabs are 
thoroughly removed. The diseased skin is then to be 
thoroughly anointed with a mixture of equal parts of oil 
of cajuput and cottonseed-oil. This anointing should be 
done quite vigorously, and is to be repeated again three 
days later, but omitting the washing with soap and water. 
Usually, after the second application the affected area 
shows sigTis of healing, and another application or two 
completes the cure. 

Fresh eruptions on other parts of the body are treated 
similarly as they appear. In chronic cases the internal 
administration of Fowler's solution of arsenic helps to 
bring about a more rapid recovery. 



60 SPECIAL EQUINE THERAPY 

EFIDEOSIS 

Abnormal activity of the sweat glands is termed epidro- 
sis. It is a condition that occurs in horses as a clinical entity 
and, while not of very frequent occurrence, it does occur 
frequently enough to be given some consideration. The 
condition usually proves to be stubborn under treatment, 
and therefore cannot be said to be a benign disturbance. 

Epidrosis occurs commonly as a symptom of various 
constitutional diseases, in which form its treatment de- 
pends upon the disease that it accompanies. In this chap- 
ter we are considering excessive sweating as a condition 
per se, a condition entirely different from the epidrosis 
seen with other diseases. 

Symptoms. A horse that is otherwise in perfect con- 
dition perspires freely when the atmospheric tempera- 
ture does not affect other horses in this respect at all. In 
some cases the entire body is moist with sweat, while in 
others only certain parts, such as the neck, withers, flank, 
or the abdomen, alone become moist. This occurs while 
the horse is at rest as well as while it is active. In some 
cases the condition is only evident at night, and it per- 
sists even during the cold weather of winter months. In 
every other regard the horse is normal. 

Treatment. If the coat is "woolly," the horse should 
be clipped. The medicinal treatment is empirical and 
experimental. Some cases are benefited by repeated 
small doses of aconitin, giving one one-hundred-and-fif- 
tieth of a grain three times a day for a few days, then 
twice a day for several more days, and finally only once 
a day for another week. 

Other cases may be completely cured by bathing the 
entire body several times with a mild solution of alum. 
The sweating can always be temporarily checked by 
small doses of belladonna, repeated two or three times. 



INTERNAL HEMORRHAGE 61 

INTERNAL HEMORRHAGE 

Bleedng from a large vessel in one of the cavities of the 
body occurs occasionally in equine subjects. A hemor- 
rhage of this kind may follow a hard pull on a heavy 
load after a period of idleness, and in such instances may 
be confused with azoturia. Moderate internal bleeding 
does not provoke marked symptoms aside from the altered 
character of the pulse. Serious internal hemorrhages are 
accompanied by trembling of muscle groups in all parts 
of the body, the horse appears drowsy, and may perspire 
in spots. The pulse is thready and fast; the tempera- 
ture subnormal by a degree or two. The visible mucous 
membranes soon become pale or blue-pink, and the respi- 
rations rapid. 

The prognosis is not unfavorable as long as the pulse 
can be felt at the maxilla. When the pulse becomes 
imperceptible in the glosso-facial artery the condition is 
in grave danger of being fatal. 

The important factor in the handling of an internal 
hemorrhage is the prompt diagnosis thereof. If the case 
is at first confused with something else and considerable 
time is lost, it may terminate fatally, although it may 
have come into the veterinarian's hands early enough 
for a favorable outcome had the proper treatment been 
given at once. 

The first thought in every inaccesible internal hemor- 
rhage should be atropin. From one-fourth to one-half 
grain of atropin sulphate should be given hypodermatic- 
ally. If convenient, the water used for the solution 
should be warm, so that absorption will begin the instant 
it is injected. The patient should not be moved; treat 
him where you find him, and do not allow him to be moved 
until all alarming symptoms have passed off. When it 
appears safe to the attending veterinarian, the patient 



62 ■ SPECIAL EQUINE THERAPY 

may be placed in comfortable quarters. The animal must 
be tied short so that the standing position will be main- 
tained for at least twenty-four hours. "Warmth should 
be applied to the body in the form of warm blankets, and 
if the hemorrhage has been an extensive one, tincture of 
iron ehlorid should be administered for a week. In valu- 
able animals quantities of normal salt solution may be 
given per rectum or subdermally. A dose of lime water, 
two to four ounces, may be given internally to assist the 
atropin sulphate. Lime salts favor coagulation. In 
applying warm blankets care should be taken to lay them 
on loosely; do not cinch them up. Loosen the halter, if 
tight, and allow no binding of any kind on any part of 
the horse. The object of this is to lay no hindrance in the 
way of the greatest amount of blood to come to the body 
surface, thereby lessening the quantity and the pressure 
in the region of the hemorrhage. 

In aged horses considerable time may elapse before 
they again attain their former vigor and stamina after a 
severe hemorrhage. Young horses, as a rule, recuperate 
rapidly; frequently a few days of rest and good care 
suffice to bring them back to normal condition. 



PSEUDO-HYSTERIA 63 

PSEUDO-HYSTERIA IN THE UN-SEXED MALE 

In geldings we may occasionally meet with a set of 
symptoms, apparently nervous symptoms, peculiar to 
themselves. The subjects thereof are without exception 
high-strung, spirited animals. In every instance that 
has come to my attention they have a nervous tempera- 
ment, and are possessed of one or more bad habits, such as 
biting, striking or cribbing. Lacking these, they are what 
is usually termed ' ' cranky. ' ' Only geldings possessed of 
"defective" temperaments such as these develop attacks 
of pseudo-hysteria. 

Symptoms. The attack comes on suddenly, and 
usually while the animal is at rest in the stable. The 
manifestations range in severity from a mild effort at 
obtaining freedom to methodical outbursts of studied 
viciousness. In rare cases the manifestations take the 
form of ridiculous antics, such as shying in the stall at 
imaginary objects, striking at imaginary objects, and so 
on. In one case under my care the gelding would stand 
for hours swinging and jerking his head in exact imita- 
tion of a horse resisting bot flies. Another case persisted 
in standing on the edge of his manger with his forefeet. 
When taken out of his stall he acted normally. As soon 
as returned he again assumed the position on the edge of 
the manger. He did this for three days, after which he 
again became normal. During the time that the attack 
was present he showed nothing that could be called abnor- 
mal, aside from his mania for standing as described. 
Other cases refuse to remain tied, or even object to con- 
finement in a box-stall. A gelding that I saw recently 
gave every indication of being violently insane when 
forced to remain in the box-stall he had occupied will- 
ingly for many months. This mania lasted nearly three 
days, and abated temporarily as soon as he was turned 



64 SPECIAL EQUINE THERAPY 

into a lot. After three days of such exhibitions he again 
became as normal and docile as he ever had been. 

Attacks of pseudo-hysteria persist, with intermissions 
of quiet, for from one to three days. They are to be dif- 
ferentiated from staggers, various forms of poisoning, 
and rabies. The chief difference is that in staggers there 
is lack of orientation. The hysterical gelding is fully 
aware of what he wants to do, and he does whatever he 
wants to do (or what his particular form of hysteria 
makes him do) , methodically and persistently. The horse 
with staggers of a violent type has apparently lost all 
sense of direction and proportion. 

Poisoning, belladonna, hyoscin and cocain poisoning 
are to be considered. 

Rabies can be excluded from the fact that there have 
been no premonitory signs, and that the actions in the dis- 
ease under discussion, although at times violent, are 
methodical and apparently performed with a distinct 
purpose. 

Treatment. If the patient's actions are of a violent 
nature, he should be given his freedom in a lot or pasture. 
Some cases respond satisfactorily to an eighth of a grain 
hyoscyamin, hypodermically. Others improve rapidly 
on small doses of atropin sulphate. Chloral hydrate and 
bromides are of benefit in those of a violent form. A 
drastic purge will check some cases with marvelous 
rapidity. 

Prognosis. This is always favorable under treatment. 
The duration of an attack can, with all propriety, be pre- 
dicted as terminating under three days. The pathology 
is unknown, or disputed. 



HYDROCEPHALUS 65 

PERMANENT INTERNAL HYDROCEPHALUS 

The presence of fluid in abnormal and permanent 
amount within the ventricles of the brain produces a 
pathological state in the affected animal. This patho- 
logical condition has been described by various writers 
under such names as chronic internal hydrocephalus and 
chronic dropsy of the ventricles. Among horsemen the 
horse so affected is called a ' ' dummy. ' ' 

Permanent dropsy of the ventricles may follow any 
acute disease of the brain and spinal cord, or their 
meninges. In other instances it develops gradually as 
the result of slowly progressing anatomical changes in the 
region of the ventricles. In all cases the symptoms pro- 
duced ensue from the effects of increased intra-cranial 
pressure. 

Symptoms. The best description of the symptoms in 
this condition is conveyed by the name which horsemen 
have given it, namely, "dummy." Horses that are the 
subjects of a permanent internal hydrocephalus appear 
to possess only a fraction of normal alertness and vivac- 
ity. The physiognomy at once betrays the low degree 
of consciousness ; the expression is almost comparable to 
that of idiocy. The horse performs a variety of abnor- 
mal movements in connection with feeding, drinking and 
other ordinary functions. Grotesque and odd positions 
of the limbs are frequently assumed. The horse at times 
leans against objects, rests the head on railings, posts 
or mangers, appearing partly asleep in the act. "While 
eating, the animal frequently pauses, standing idiotically 
for variable periods of time with a partly masticated 
bolus of feed or hay held in the mouth. While drinking, 
the horse frequently immerses the head to the eyes, sud- 
denly and surprisedly jerking up the head as it finds the 
water entering the nares. 



66 SPECIAL EQUINE THERAPY 

The condition runs a slow course, becoming more 
marked month, by month. Soon the animal finds it 
impossible to move in a straight line, and usually back- 
ing becomes difficult. If the animal is forcibly and 
quickly shoved backward it will either fall or flounder 
clumsily about. 

In some cases the horse has spells of violent attacks. 
These last for several hours at times, during which the 
animal presents a set of symptoms generally described 
as staggers. It plunges about, falls, rises again, and 
goes through similar antics frequently. In one case oc- 
curring in my practice a violent spell of this sort lasted 
nearly forty-eight hours, during which time the horse 
succeeded in completely demolishing its stall and eventu- 
ally broke loose and ran amuck. It was later recap- 
tured in an exhausted, sleepy condition. 

"Dummies" eventually become wholly unserviceable. 
The condition is always incurable. In the early stages 
it is recognized by testing the alertness and the acute- 
ness of sensibility, as well as by noting the progressive 
development of permanent sluggishness. These horses 
always have a slow, full, soft pulse ; and in nearly every 
case the respiratory motions are abnormally slow and 
deliberate. The horse is not easily excited by noise that 
formerly alarmed it, and it responds slowly or not at all 
to slapping, or to commands. Violent spells, such as 
have already been described, can frequently be aroused 
by making the horse perform unusually hard work, and 
at times by confinement in hot stables during extremely 
hot weather. Because of the possibility of an unexpected 
violent spell of this kind, horses so affected should be 
considered unsafe and dangerous. 

Treatment during these spells is wholly symptomatic. 
Treatment of the condition itself is useless. 



MENINGISM 67 

MENINGISM 

Meningism has been defined by various writers as a 
sub-acute or mild meningitis, which may be cerebral or 
spinal and which quite frequently is cerebro-spinal. The 
etiologie factor is said to be, in almost every instance, 
an auto-intoxication of intestinal origin. It affects horses 
in nearly all parts of the United States, showing a pref- 
erence for young animals, from sucking colts to those 
just short of maturity. A predisposing cause is idleness 
and an unbalanced ration. Most cases are seen during 
the winter months. 

Symptoms. Animals affected at first show slight in- 
disposition, appear sluggish, are "off feed," and do not 
lie down. At this time there is a rise in body tempera- 
ture of from three to five degrees Fahrenheit. The pulse 
is full and slow. Within a few days the animal shows 
some difficulty in swallowing. There is beginning a lack 
of coordination in the movements of the hind legs. Those 
which lie down are unable to arise without assistance. 
The temperature becomes sub-normal in most cases after 
the inaugurating fever subsides, usually at the end of 
several days. Constipation is usually evident. In some 
cases the early symptoms are so mild that the first thing 
noticed is the lack of coordination in the posterior mem- 
bers. The animal has a "wobbly" gait and, in turning 
quickly, may fall, 

A few cases may be ushered in with more force. The 
animal appears distressed, shows signs of wanting to 
"forge ahead," pushing forward against the manger 
or into a corner. There may be a slight rigor. After 
twenty-four to forty-eight hours the case assumes the 
more sub-acute aspect first described. The symptoms 
enumerated slowly disappear, with the exception of the 
lack of coordination in the posterior members. This 



68 SPECIAL EQUINE THERAPY 

may hang on for months, even with treatment, and in 
some cases remains permanently. The mortality is very 
low, probably not more than two per cent. Cases in 
which the early symptoms have passed unnoticed, may 
be found down, unable to rise. 

The condition must be differentiated from azoturia, 
and from injuries to the lumbar or sacral region. In 
some exceptionally well marked cases there is ptosis af- 
fecting one eye-lid. 

Treatment. Cases that are found down should be 
given from one-fourth to three-fourths grain of atropin 
sulphate, hypodermically, before anything else is done. 
This gives marvelously prompt results in many of these 
cases; the animal frequently rises without assistance in 
an hour or two thereafter. 

In those eases which come into the veterinarian 's hands 
in the early stages, a purging dose of arecolin or eserin 
is indicated, but it is a question whether this is good 
treatment, everything considered, because of the addi- 
tional effusion that may occur into the meningeal spaces 
as a result of the action of these drugs. I have treated 
animals affected with this disease by giving arecolin and 
coordination was more interfered with than in cases 
where arecolin was not used. For that reason I say that a 
purging dose of arecolin or eserin (basing our treatment 
on the intestinal stasis) would be indicated. While the 
early signs of the disease are in almost every case 
promptly checked by a dose of either of these drugs, I 
do not recommend their adoption as routine medicament. 
I much prefer a cathartic dose of aloes. 

Intestinal antiseptics are to be administered from the 
beginning and should be kept up for at least a week. 
Either salol or the sulpho-carbolates compound can be 
used, giving half-dram doses of the former and sixty- 
grain doses of the latter. 



MENINGISM 69 

In the beginning, a few large doses of liexamethylena- 
min often prove very beneficial. A two-dram dose can 
be given freely diluted with water, until at least three 
doses have been given, allowing two or three hours to 
elapse between doses. The intestinal activity should be 
encouraged by repeated small doses of fluid extract of 
cascara sagrada, or by small doses of magnesium sulphate. 

In those cases in which the initial symptoms are marked 
by a tendency to move forward and by pushing the head 
against objects, blood-letting gives fine immediate results. 
The patients should be kept in dry, warm and roomy 
quarters and should have free access to fresh water. 

In most cases of meningism, during the course of 
which the animal assumes a recumbent position and then 
is unable to rise, the animal will gain the standing posi- 
tion with slight assistance, such as lifting at the tail. 

Those cases in which the lack of coordination persists 
after all other signs of the disease have disappeared 
should receive a prolonged course of treatment with iodid 
of potassium. If the progress towards improvement is 
slow, Fowler's solution of arsenic should be alternated 
with the iodid of potassium. The iodid can be given 
for a week and then a week of arsenic administration. 
This should be continued until improvement is evident, 
after which the iodid of potassium is to be given alone 
until the recovery is complete. While under this treat- 
ment for the correction of the coordinative loss the animal 
should have light exercise. In a few cases complete recov- 
ery seems impossible. If recovery has not taken place 
after four or five weeks of potassium iodid treatment, 
the case is usually incurable. 

The differential diagnostic mark between meningism 
and true cerebro-spinal meningitis is the lack of opis- 
thotonie fixation of the body. In true inflammatory con- 
ditions of the meninges, opisthotonos occurs when the 



70 SPECIAL EQUINE THERAPY 

patient is urged to get up. The head is raised, the neck 
is flexed in a backward direction and the fore-legs are 
stiffly extended. In meningism this does not occur. The 
body remains flaccid. This diagnostic mark is positively 
reliable. 

VERTIGO OF YOUNG HORSES 

This is a condition that is not very well understood 
from an etiological, or from a pathological, standpoint. 
It is an affection that confines its appearance almost 
wholly to colts, from the first to the fifth year of life. 
Breed, sex and condition do not seem to have any bearing 
on its occurrence. It is seen in poorly nourished colts 
with no greater frequency than in well fed individuals. 

Symptoms. The symptoms in this condition appear 
intermittently and irregularly. Between the attacks the 
colt is in perfect health and quite careful examination 
fails to disclose any evidence of the disease. An attack 
of vertigo is ushered in with symptoms of confusion. This 
is of very short duration, not longer than a minute or 
two, and is immediately followed by staggering, stum- 
bling and decubitus. The colt lies quietly on the ground 
for a few seconds, apparently only partly conscious. It 
rises, shakes itself ; it may then whinny, and appear to be 
in perfect health. 

Another attack may come within a few days there- 
after, or it may take several weeks before another attack 
occurs. As the colt becomes older the attacks become 
milder, so that the animal merely stumbles to knee po- 
sition but does not lie. The periods between the attacks 
are prolonged until at maturity the attacks are no longer 
noticeable. From this it would seem that the condition 
has something to do with glandular secretions bearing 
upon the attainment of maturity. 

Vertigo in colts is only serious when it occurs in ani- 



VERTIGO 71 

nials that are already old enough to work. The precipi- 
tation of an attack while the animal is in harness may 
result in injury to the horse as well as to the driver 
thereof. 

Treatment. As the attack rarely lasts over a few min- 
utes, nothing is needed in the line of treatment that can 
be of service during the attack. The veterinarian, if 
called, never arrives in time to witness an attack. It can 
do no harm to endeavor to prevent the recurrence of 
attacks by the use of alterative and tonic treatment, 
although it is extremely doubtful whether any form of 
treatment would accomplish this. It usually suffices to 
assure the client that the attacks are not serious and that 
they will eventually subside altogether. 

The development of a somewhat nervous disposition 
is an occasional sequel of vertigo in young horses. 
Whether this is a direct effect of the disease, or merely 
apprehension psychosis, I am not able to say. 



72 SPECIAL EQUINE THERAPY 

COUGHS 

Coughing in horses is a subject worthy of a separate 
chapter in any book on equine therapeutics. To prop- 
erly diagnose and correctly treat coughs in their varied 
forms is no small accomplishment. It is to be regretted 
that for many veterinarians a cough is merely a cough. 
The same ' ' cough mixture ' ' or treatment does service for 
some practitioners whether the cough be due to a cold, 
laryngitis, or heaves. 

While in a great many cases a cough is merely a symp- 
tom of other disease conditions, there are presented for 
our consideration fully as great a number of cases in 
which the cough is the chief symptom — in fact, the only 
symptom that we are expected to correct. All of us 
are familiar with the "Doctor, can you give my horse 
something for his cough ? ' ' question ; we hear it almost 
daily. If we are anxious to do our client a good turn, and 
our profession credit, we do not settle this question with 
a dose of made-to-order "cough mixture." We make 
an effort to get a good history of the case first of all. 
How long has the horse been coughing? When does he 
cough most; in the morning, after eating, while eating; 
or does he cough at all hours with equal severity? 

When we have ascertained this, we are ready to exam- 
ine the patient, and the examination usually follows a 
line that has been suggested by the client 's replies to our 
questioning. We always take the patient's temperature 
before we do anything else. The thermometer can be 
relied upon to indicate whether we are dealing with an 
acute or a chronic condition ; and many times that is the 
most important item to consider in the treatment of a 
cough. The client's statements are not always reliable. 

When we have assured ourselves that the cough is not 
the result of an acute disturbance, such as colds, bron- 



COUGHS 73 

chitis, laryngitis, etc., we make an effort to classify it 
by forcing the patient to cough. This can usually be done 
by firm pressure in the laryngeal region exerted by grip- 
ping the parts firmly with the whole hand. If this fails 
to bring a cough from the patient, a smart tap over the 
middle of the trachea will often produce it. In still 
other cases a squirt of cold water into the pharynx by 
the use of a dose syringe will arouse a cough. Our exam- 
ination further includes careful auscultation of suspected 
regions — larynx, trachea and thorax. In cases pointing 
to thoracic lesions, percussion often tells us all we need 
to know for purposes of treatment. When diagnosis has 
been made, treatment is prescribed to suit the particular 
condition afllecting the individual examined. 

If we are satisfied, from the history and findings of 
our examination, that the patient coughs most markedly 
in the morning, because of a catarrhal condition of the 
pharyngeal mucous membrane, the cough being an effort 
to dislodge mucus accumulations that have collected over 
night, we give small doses of dichromate of potassium. 

A case that we decided has resulted from an improp- 
erly treated or a neglected distemper we give iodid of 
potassium. 

The patient that has a chronic cough and at the same 
time gives evidence of its becoming a roarer is given one 
ounce of a two per cent aqueous solution of tincture of 
capsicum several times daily. 

The patient with a bronchial cough is given Fowler's 
solution of arsenic. 

The cough that "hangs on" after an attack of pneu- 
monia usually does not remain long if we give the patient 
small doses of beechwood creosote in glycerin several 
times daily. 

Occasionally we meet a ease wherein there exists a dry, 
hacking cough, that is the result of an irritable state in 



74 SPECIAL EQUINE THERAPY 

the pharynx, because of a " bad mouth. ' ' The necessary 
dental attention properly executed ends the cough. 

A short, choppy, dry cough with spells of dyspnea 
may be due to a heart lesion. This must be classified and 
properly treated if possible. This class of coughing pa- 
tients usually come with a history of occasional epistaxsis. 

In this whole list of varied pathological conditions, 
and it is only an incomplete list, the predominating symp- 
tom and the symptom that brings the patient to the vet- 
erinarian, is the cough. The practitioner that is satisfied 
to treat, and tries to satisfy his client by treating all 
coughs with stock cough mixtures is not only doing poor 
practice, but is also doing poor business. Many times he 
tries to cure a ten-dollar case with a fifty-cent bottle of 
' ' cough mixture. ' ' His treatment is frequently no more 
effective than so much water. To hit a target one must 
aim before firing. 

The object of this random chapter on coughs and their 
treatment is to impress upon the general practitioner the 
futility of attempting the correction of conditions having 
such a varied pathology by the use of a common agent. 
One would show just as poor judgment were he to attempt 
the cure of all forms of lameness by the use of liniments. 
The use of stock cough mixtures by the practitioner is the 
result of "getting into a rut" more than anything else, 
and the effect of the tendency, now so general, of using 
ready-made pharmaceuticals. The alluring formula of 
the average proprietary "cough mixture," containing 
sometimes a dozen ingredients, that is offered for veteri- 
nary use by most pharmaceutical houses at a cheap price, 
makes it a "best seller." The average veterinarian, with 
little trouble, could demonstrate both a chemical and a 
physiological incompatibility in most of these cough rem- 
edies. He uses them against his own better judgment. 



PNEUMONIA 75 

PNEUMONIA 

We shall confine this discussion of pneumonia to that 
of treatment. There is in all veterinary practice no 
other disease in the treatment of which good judgment 
is so valuable as in this. If it can be said of any disease 
to which the horse is subject that "Dr. So and So killed 
him," pneumonia is that disease. Were I the owner of 
a valuable horse afflicted with this disease and given my 
choice, in the selection of a veterinarian to treat the case, 
between a recent graduate with a grip full of drugs and 
an old practitioner with nothing but a head full of good 
judgment, I would say, "Keep your young fellow with his 
grip full of drugs and give me the man with his head full 
of good judgment. ' ' I would be the last person on earth 
to lay anything in the way of the young graduate 's prog- 
ress, but I firmly believe that in most instances he is seri- 
ously handicapped in the handling of pneumonia because 
of a lack of practical experience in this particular work. 

So many young practitioners seem to forget what their 
instructors told them about pneumonia almost as soon 
as they graduate ; at least, they seem to forget the most 
important point from the side of treatment, and that is 
that you can not abort a case of pneumonia! If a prac- 
titioner knew nothing else about this disease, but had it 
indelibly ground into his brain that pneumonia is a self- 
limited disease, and that he is only lessening the chances 
of his patient for recovery when he attempts to cut short 
or interfere with its regular course, he would be suffi- 
ciently qualified for all practical ends. Such a man 
would at least do no harm to the patient. Just as soon 
as the treatment in a case of pneumonia takes the form 
of heroics it is harming the patient. I do not intend to 
modify or qualify this statement under any circum- 
stances. 



76 SPECIAL EQUINE THERAPY 

Another item that seems to have some effect on the 
young graduate's methods of treating pneumonia cases 
is that pertaining to the classification of the disease into 
different forms, such for instance as croupous pneumonia, 
lobular pneumonia, contagious pneumonia, pleuro-pneu- 
monia, and so on. On this item we can adopt another 
slogan; we should think, for purposes of treatment, of 
pneumonia as an inflammation of the lungs and their 
covering. That is enough — aside from safeguarding the 
health of other animals in cases of contagious pneumonia, 
by enforcing regional quarantines, and the possible use 
of specific or biologic agents (for prophylaxis only), the 
treatment applicable is the same in all casfes. 

The reader will note particularly that I say pneumonia 
is to be considered as an inflammation of the lungs and 
their coverings. I say this because I do not believe that 
a case has ever occurred, or that a case ever will occur, 
in which the pleura is not a participant. We recognize 
the involvement of the pleura only when the symptoms 
produced by its involvement equal or over-shadow those 
of the pneumonitis. When the participation of the 
pleura is so nominal that the symptoms do not betray the 
involvement, we are content to believe that there is no 
pleurisy. 

From what has just been said I do not wish to have 
the reader arrive at the conclusion that a case of pneu- 
monia requires no care. On the contrary, the correct 
and successful handling of an attack of pneumonia is 
not a very simple matter. 

The treatment of pneumonia should have as its main 
object : 

1. To give such assistance to the defensive and con- 
structive forces of the patient's system as will make it 
more easily possible for the patient to survive. 

2. To incorporate into this assistance such treatment 



PNEUMONIA 77 

as will have a tendency to prevent complications and 
disagreeable sequelae. 

3. To shorten the period of convalescence. 

Under 1 : Stimulants, tonics, hygiene, suitable diet, 
nursing. 

Under 2: Baeterins, serums. 

Under 3 : Alteratives. 

The clinical evidence, and the post-mortem findings in 
fatal eases, absolutely rule out depressants in the treat- 
ment of pneumonia. This evidence demonstrates con- 
clusively that nearly all antipyretics are heart depres- 
sants and they are therefore contra-indicated. 

In my own practice I start the handling of every case 
of pneumonia with a counter-irritant, usually a common 
mustard plaster. "While I can not point out any good or 
authoritative reason for this use of a counter-irritant, 
I do know that it has much good in it. This good effect 
may be only of a transient character; one would almost 
dare say that it was psychological in character. Never- 
theless, it is very evident, and very promptly so. Im- 
mediately after the application of a good mustard plaster 
there is a change in the patient ; it seems to put him into 
shape for the fight he is about to enter. Case after case 
I have had in which the horse, in my opinion, owed his 
recovery from the attack of pneumonia to this old-fash- 
ioned mustard plaster, more than anything else. 

As routine internal medication, nux vomica or strych- 
nin must be given the first place. The constancy of the 
effect produced by repeated correct doses of nux vomica 
is very gratifying. The same effect can not be obtained 
with strychnin alone. My method is to give from one- 
half to one dram of fluid extract of nux vomica every 
three hours during the day. I do not increase this dose 
unless there are signs of an impending crisis. I then 
give one-fourth grain strychnin sulphate hypodermieally 



78 SPECIAL EQUINE THERAPY 

at such times as the symptoms (chiefly the heart action) 
call for it. If strychnin alone is used throughout, the 
appetite does not remain so good as it does when nux 
vomica is used, and the effect of strychnin alone is not 
so constant. 

I would give second place to spartein sulphate as rou- 
tine internal medication. Given in about twenty-grain 
doses, orally, it has shown evidence of producing some 
fine results. I do not think that it gives as uniformly 
gratifying results as nux vomica. Spartein sulphate 
seems to greatly relieve the heart in those cases marked 
by a genuine crisis; but apparently it exacts the limit 
of heart power from the very beginning, leaving no re- 
serve force that can be called into action when it is of 
the most vital importance. In this reserve force and its 
being called upon and brought into action at just the 
proper time lies one secret in the successful handling of 
pneumonia cases. It is doubtful whether it is possible 
to gain this knowledge in any other manner than by 
actual contact with the disease in practice. 

It is good practice to inject every patient in pneu- 
monia cases with a moderate dose of polybacterins. This 
has clinically been shown to be of great worth for the 
prevention of complications that might result from the 
activity of pus-producing micro-organisms. The bac- 
terins should be given on the day that treatment is begun. 
All other medication in pneumonia patients takes the 
form of symptomatic treatment. 

If constipation develops, fluid extract of cascara sa- 
grada is given in half-ounce doses morning and evening 
as long as necessary. The effect of the cascara in these 
cases is enhanced if each dose is given with two ounces 
of sodium thiosulphate, in aqueous solution. 

A troublesome diarrhoea is most easily subdued with 
hourly thirty-grain doses of sulphoearbolates compound 



PNEUMONIA 79 

ill conjunction with twenty drops of tincture of capsicum. 
The sulphocarbolates alone do not give the desired result. 

Patients that do not eat can in many instances be 
brought into good appetite by a few doses of lemon juice. 
The juice from two or three lemons makes an average 
dose, and can be repeated a few times. It is to be given 
with a dose syringe. Others are tempted with fresh 
vegetables, of which carrots are usually the most accep- 
table. A good, seasoned bran mash containing a, few 
finely sliced carrots will frequently be eaten when every- 
thing else is refused. Feed that is not promptly eaten 
by the patient should be removed from the manger. A 
pail of fresh water should be constantly within reach of 
the patient. The patient may be blanketed or not, de- 
pending upon the temperature of the stable, the presence 
of air currents, etc. 

One feature of great importance in the successful han- 
dling of pneumonia cases is the supply of fresh air that 
the patient must have. Were I to choose between treat- 
ing a case of equine pneumonia in a poorly ventilated 
stable and the open, even in extremely cold weather, I 
would choose the open. Ventilation of a stall is not al- 
ways practicable, especially in the ordinary basement 
stable usually built on farms. In a stable such as this 
fresh air usually means cold air admitted in such a man- 
ner that it will chill the patient. Under these conditions 
better results will be obtained from the use of an out- 
house or shed to which fresh air has free access con- 
stantly. When this sort of an abode is resorted to the 
patient must be amply provided with blankets, a hood, 
and leg wrappings. The wrappings applied to the legs 
should consist of a layer of cotton under flannel ban- 
dages, loosely put on. Under all conditions the patient 
should be subjected to a daily application of curry-comb 
and brush, thoroughly manipulated. 



80 SPECIAL EQUINE THERAPY 

Cases ill which resolution is tardy can usually be hur- 
ried along by the administration of five or six doses of 
iodid of potassium, giving a dram at each dose, at inter- 
vals of four to six hours. This may "knock out" the 
patient 's appetite ; if it does, the iodid administration is 
to be stopped at once. 

Cases complicated with pleural effusion of such amount 
as to produce dyspnea should be tapped. This opera- 
tion can often be delayed until the patient is in fair con- 
dition to go through the ordeal. A quarter to a half 
grain of strychnin sulphate given hypodermically half 
an hour before the operation will fortify the patient 
against ensuing shock. 

Cases complicated by the development of empyema 
do well under large doses of echinacea. If conditions 
are favorable for properly irrigating the pleural cavity 
after the contents have been drawn off it should be done, 
using either normal salt solution or a very mild solution 
of chinosol. 

Coughs that remain after recovery from an attack of 
pneumonia are best treated with beechwood creosote in 
glycerin. 

Cases that run a slow and indifferent convalescent 
course should receive potassium iodid and Fowler's solu- 
tion of arsenic alternately. 

Some cases that are slow in regaining their former 
vigor can be brought to prompt improvement by the 
injection of one large dose of anti-streptoeoccic serum. 

In summing up the items of importance in the han- 
dling of patients afflicted with pneumonia, I would men- 
tion again: 

1. Avoid anything and everything the effect of which 
is depressing. Do not allow yourself to be moved into 
using antipyretics, especially coal-tar products, in your 
efforts in controlling the fever. The fever subsides spon- 



PNEUMONIA 81 

taneously if you follow the instructions already outlined. 
It would be a physiological impossibility for the patient 
to overcome the pathological condition attacking him 
without the presence of a rise in body temperature. 

2. By good nursing, sanitation, hygiene and enticing 
feeds, endeavor to keep the patient cheerful. As long as 
he is cheerful he will eat ; and as long as he is eating well, 
he is making good progress. In no other disease is the 
appetite such a good index of the patient's condition. 

3. If it is not possible, or practicable, to arrange suf- 
ficient and proper ventilation in the stall, have the horse 
put out of doors. Fresh air is half the treatment. 

4. Make it a point to observe your patient with espe- 
cial care from the fifth to the eighth day of his attack. 
While many cases of pneumonia in horses come to reso- 
lution without marked crises, nearly as many do go 
through a genuine crisis. This is generally forecast 
by an additional rise in temperature, by increased respi- 
ratory difficulty, restlessness and capricious appetite. 
Occasionally there is a slight rigor. When these signs 
appear on from the fifth to the eighth day, meet them 
with strychnin. Give small doses hypodermically every 
four or five hours if need be. If it is not convenient to 
administer hypodermically instruct the attendant so that 
he may give it per rectum. 

5. Remember that a single dose of mixed bacterins 
given early in the attack will almost positively prevent 
empyema. 

6. Begin the treatment of all cases with a good mus- 
tard plaster. 

No great strides have been made in the treatment of 
pneumonia. Even in human medicine, where every op- 
portunity and facility for improvement exists, the treat- 
ment of pneumonia is today practically the same as it 
was a generation or two ago. This is not because no 



82 SPECIAL EQUINE THERAPY 

efforts have been made to find a different or a better 
treatment — in fact, the subject of the treatment of pneu- 
monia has received fully as much study as any other. 
The disease itself is the only answer — it can not he 
aborted; it is self -limited. The nature of the tissue 
which is the seat of pneumonia is such that an inflamma- 
tion once established within its cells can only terminate 
by resolution after certain stages (fully understood by 
all pathologists) have been passed through. All im- 
provement in the treatment of pneumonia must therefore 
end, as a matter of course, with such innovations having 
to do with the prevention of complications and sequels. 
Just as soon as the practitioner comes to look at his 
pneumonia cases from this angle he has only occasional 
losses. As long as he adheres to heroic treatments, en- 
deavoring to abort the attacks or to bring them to a rapid 
termination, he experiences only occasional recoveries of 
his patients. 



ATROPHY OF THE LIVER 83 

ACUTE YELLOW ATROPHY OF THE LIVER 

This is a rare disease in general. In the neighborhood 
of smelters and paint works it occurs often from the in- 
gestion of foliage soiled with poisonous fumes or smoke. 
As an accidental disease it may occur in any region at 
any time after an animal indulges an abnormal appetite 
on articles containing phosphorus or other active poi- 
sons. Also, as a sporadic disease, it may develop from 
unknown causes at any time in any locality. However, 
as has been pointed out, the disease is a rare one. In a 
life-time of practice one might see half a dozen cases. 

From a pathological standpoint the disease is an acute 
fatty degeneration of the liver cells, which runs its course 
in a few days, and in almost every instance terminating 
in death. 

The onset of an attack of acute yellow atrophy of the 
liver is always sudden. Usually the attack begins with 
a mild colic. The pains are not severe and do not remain 
long, an hour or two at the most. They are at once fol- 
lowed by the symptom complex about to be described. 

First, with the disappearance of the colicky pains, 
there appears great depression. This is so marked as to 
resemble severe shock. The pulse is lost, and the tem- 
perature, which was raised several degrees during the 
time the colic persisted, begins to drop. In a few hours 
it may be several degrees subnormal. 

Second. The visible mucous membranes are icteric. 
At first only a slightly yellow tinge is seen, later they 
become a dirty brown, or a greenish brown. 

Third. An uncontrollable diarrhoea sets in. The evac- 
uations are at first normally colored, later they become 
pale yellow, and finally have a gray tint. Before death 
occurs these evacuations assume a thin, watery east and 
give off a very disagreeable odor. Evacuation foUows 



84 SPECIAL EQUINE THEFvAPY 

evacuation; the patient stands now in an exhausted, re- 
signed attitude. Muscular tremors and perspiration 
appear, and soon recumbency and death. A horse in the 
grip of this disease is a pitiable sight to behold. The 
disease runs its course in from two to four days. During 
this time the patient will not refuse all feed, but from 
time to time may nibble some oats. These appear, undi- 
gested, in the evacuations within a few hours. The urine 
is very dark in color. 

Nothing will check the course of the disease so far as 
is now known. In one case which occurred in my prac- 
tice, I had ample opportunity and every facility and 
inducement to attempt a cure. Everything was useless. 
Until the etiology and the pathological changes which 
occur are better understood, we can expect to make but 
little impression on an attack with our treatment. The 
disease runs such a rapid and violent course that any 
form of handling, to be successful, ' ' must hit the nail on 
the head." Until we can do this these cases will con- 
tinue to be always fatal. 

On account of the infrequent occurrence it may not 
be possible to solve the problem presented by this disease 
for a long time to come. Experimental handling of 
these cases would, therefore, be entirely ethical and per- 
missible by veterinarians in attendance on animals so 
affected. Under our present form of treatment and un- 
derstanding of this disease, death is always a foregone 
conclusion. At autopsy the liver is greatly shrunken 
or reduced in size and very friable. 



JAUNDICE 85 



JAUNDICE 



Jaundice, or icterus, is the name given to the condition 
produced by the repression, or else by the reabsorption, 
of the biliary secretion. The condition results from 
repression of the biliary secretion in such affections 
of the liver as cirrhosis. It results from reabsorption 
of the bile when there is an obstruction in the bile duct, 
such as calculi, new-grovi^ths, catarrhal inflammation, 
etc. 

Symptoms. These vary in severity witH the amount of 
interference in the biliary output. "When jaundice is 
fully established it is frequently a grave and stubborn 
condition. The horse eats little or not at all. There is 
an alternating rise and fall in the body temperature; 
slight exertion frequently produces attacks of tachycar- 
dia. The clinical picture may change several times a 
day. At certain hours the patient is apparently in fair 
health, while possibly at other hours of the day the symp- 
toms again become marked. The visible mucous mem- 
branes, especially the conjunctiva, are of a cast from 
yellow to yellow-green. The color of the urine which 
the patient voids is either dark brown or greenish in color. 
The feces are at first slightly lighter than normal in 
color; later they become greyish. After the ingestion 
of food the animal may exhibit slight colicky pains. An 
attack of jaundice may disappear in a few days, or it 
may remain for several months, depending upon the 
etiology. 

When the jaundice is clearing up there is in some cases 
a severe pruritis. The animal will mutilate itself in its 
attempts to scratch itching portions of the body, fre- 
quently resorting to the use of its teeth. No doubt some 
of the eases of self -mutilation that have been reported 
were due to jaundice. During the entire time that the 



86 SPECIAL EQUINE THERAPY 

condition persists the affected animal is weak, listless, 
and incapable of performing its usual work. 

The prognosis is favorable in cases due to catarrhal 
obstruction or calculi. It is unfavorable in all cases due 
to structural changes in the liver or its ducts. 

Treatment. No matter in what form the condition 
appears, one of the most essential features in the treat- 
ment is rest. Even slight exertion has a tendency to 
delay recovery and aggravate the symptoms. 

Because of the difficulty of differentiating the various 
forms clinically in the horse, all attacks of jaundice are 
given such treatment as would appear most appropriate 
in the catarrhal form. The nature of all other forms is 
such that, in the horse, their correction is at least im- 
practicable if not impossible. 

Repeated doses of epsom salts, of sodium phosphate, 
or of other saline laxatives, are given daily. These doses 
are to be just large enough to produce a mild laxative 
effect ; purgation is rather more harmful than beneficial. 
The feed should be nutritious and easily digested. Stom- 
achics and some form of internal antiseptic should be 
given together. 

Some cases that resist the above line of treatment re- 
spond quickly to repeated doses of sodium bicarbonate 
and infusion of rhubarb. Small doses of essence of pep- 
permint enhance the effect of the two latter agents. 

Some cases that have resisted all other treatment will 
recover with the use of iodid of potash, Phytolacca and 
colchicum. 

When the pruritis incident to the convalescent period 
begins, the horse must be prevented from injuring itself. 
Alkaline body-washes may be used to lessen the pruritis. 
Usually, however, there is not much benefit derived from 
any sort of applications for this purpose. 

The case may be considered on the road to recovery 



LEUKEMIA 87 

when the urine clears up and the feces again assume a 
normal color. The icteric cast of the mucous membranes 
may persist for a long time after all other symptoms of 
the disease have disappeared. 

LEUKEMIA 

This disease has only very rarely been reported in 
horses, being, no doubt, frequently mistaken for other 
diseases having a similar general course. The actual 
diagnosis of leukemia in any form is only possible by 
laboratory methods. 

Leukemia occurs in two forms; first, myelogenous 
leukemia, which affects chiefly the leukocytes; second, 
lymphatic leukemia, in which the lymphocytes are chiefly 
concerned. The etiology is unknown. 

Symptoms. Leukemia affecting horses is said to occur 
always in a very gradual, insidious manner. There are 
at first only signs of general debility, lack of endurance 
and weakness. There may be a degree of pulmonary 
dyspnea. Later the mucous membranes assume a pale, 
almost white color. Heart lesions develop, edematous 
swellings appear in various regions, and the lymphatic 
glands throughout the body become very much enlarged. 
Splenic hypertrophy is always present. There may be 
general soreness in movement, said to be due to involve- 
ment of bone marrow. 

When the disease has become well established there is 
a tendency toward hemorrhage, such as epistaxis. The 
blood which so issues is pale and thin. Death occurs 
from inanition, cachexia, or from internal hemorrhage. 
The course of the disease may extend over a number of 
years. The prognosis is unfavorable. 

Treatment. Leukemia is only rarely treated as such 
because a diagnosis is not often made of the true condi- 



88 SPECIAL EQUINE 'iHERaPY 

tion. And, even when the condition is actually diag- 
nosed, the treatment is wholly of a symptomatic char- 
acter. Good food, light work, tonics such as arsenic and 
iron, and good hygienic surroundings accomplish all that 
can be expected. The termination is almost without ex- 
ception fatal, and it is only possible to slightly delay this 
termination. 



DIABETES INSIPIDUS 

For some reason or other this has come to be a very 
rare pathological condition. In my opinion this reason 
can be found in the now prevalent custom of treating 
grain with formaldehyd to prevent mould. While the 
exact pathology of diabetes insipidus was not fully un- 
derstood, it was quite generally held that it was the 
result of an infection with some form of mould taken in 
on the feed. The prevailing custom of treating grains 
with formaldehyd and the coincident decrease in the 
number of cases of diabetes insipidus would, to a certain 
extent, strengthen this hypothesis. 

The predominating symptoms in this disease are great 
thirst and frequent urination. The affected animal sud- 
denly develops a great thirst. It will drink from four 
to six times the normal quantity of water, and at every 
opportunity. If no drinking water can be reached the 
animal will drink anything liquid, such as sewer water, 
rain water, urine, etc. At the same time micturition is 
frequently performed, great quantities of urine being 
passed at each act. After the condition has existed for 
three or four days there is much straining and dribbling 
of urine at the end of each urinary act. The appetite 
now becomes capricious, and in another day or two the 
patient refuses all food, retaining only an unquenchable 



DIABETES INSIPIDUS 89 

thirst. Exhaustion, emaciation and death are next in 
order. 

Diabetes insipidus must be differentiated from simple 
polyuria. The latter is a transient condition free from 
constitutional disturbances, and disappears spontane- 
ously. Diabetes insipidus persists for weeks, slowly in- 
creases in severity, and frequently terminates in death 
if proper treatment is not instituted. 

Treatment. Begin the treatment of a case of diabetes 
insipidus with the administration of a dram of resub- 
limed iodin. Give this in a capsule with a little pow- 
dered gentian. With few exceptions this is all the 
medicine that is required. 

The remainder of the treatment is concerned with lim- 
iting the supply of drinking water. Allow at first about 
twice the normal amount; gradually reduce this to nor- 
mal and eventually to less than normal for a day. This 
controlling of the amount of drinking water imbibed by 
the patient must be done very gradually, reducing the 
quantity in proportion to the reduction of urinary excre- 
tion. "With the administration of the iodin and sensible 
control of the drinking, even very marked cases come to 
a satisfactory termination within two or three days. If 
improvement does not show within twenty-four hours 
after the iodin has been administered the same dose may 
be repeated once. 

When the appetite returns the grain supply should 
be fresh, so as to prevent reinfection in case the animal 
had been fed mouldy grain. While the iodin treatment 
and the control of the water supply promptly puts an 
end to the alarming symptoms, the patient usually re- 
mains in a weak, unthrifty condition for some time. Even 
when the attack has persisted only for a few days the 
horse is usually much the worse in condition at its ter- 
mination. When an animal has gone through a marked 



90 SPECIAL EQUINE THERAPY 

attack of diabetes insipidus, a long rest is usually re- 
quired before the customary well being is reestablished. 



DIABETES MELLITUS 

Diabetes mellitus may be described best as the "sugar 
disease. " It is characterized by an excess of grape sugar 
in the blood, which excess is excreted in the urine in its 
true state as grape sugar. Diabetes mellitus is much 
more common in horses than is generally held to be the 
fact. True, it is, comparatively speaking, a rare disease ; 
but it appears frequently enough to make a knowledge 
of its manifestations essential. 

The disease runs a slow, chronic course, lasting from a 
few months to several years. While spontaneous recov- 
ery is possible, the termination is nearly always fatal. 

The pathology is not really understood. Pancreatic 
insufficiency is quite generally presumed to be a factor 
in the causation. 

Symptoms. The first signs of diabetes mellitus are, 
what describes it best, a "lack of pep." The horse does 
not come up to his usual standard in condition and work- 
ability. Signs of fatigue are common at ordinary exer- 
tion. The animal perspires more easily than it should, 
and usually the client says that "his feed does not seem 
to do him any good," despite the fact that his appetite 
does not seem to be interfered with. The condition may 
remain unchanged for months. Tonics, or whatever else 
may be given, do no appreciable good to the animal. As 
the disease progresses, the horse loses in condition. The 
appetite remains good, and very often becomes almost 
ravenous. Thirst is almost constant; the horse accepts 
every opportunity to indulge this sense. 

It is now noted that the animal is becoming "tender- 



DIABETES MELLITUS 91 

skinned"; wherever the harness rubs, abrasions occur. 
The points of the hips and the sides of the elbow, the 
sides of the carpus, hock and head are bruised from the 
slightest contact with parts of the stall in lying down 
and rising. 

At this stage of the disease a very common manifesta- 
tion is a suppurative coronitis, frequently affecting all 
four feet. We have not noticed in our patients the de- 
velopment of ocular lesions described by some authors. 
During the entire course of this disease there is polyuria. 
The degree of polyuria is not always equal ; at times the 
urinary output only slightly exceeds the normal, while 
at other times great amounts of urine are passed every 
hour or two. The urine is clear in color and has usually 
a sweet-sour odor. If voided on wooden floors it leaves 
the soiled area covered with a whitewash-like film after 
evaporation. Most cases of diabetes mellitus do not come 
to an end in death as a result of the disease itself. In 
most cases the horse dies from complications which do 
not show a very clear connection with it. Cases that 
run to fatal termination as a result of the progress 
of the disease terminate in marasmus, decubitus and 
death. 

Diagnosis is made positive by urinalysis, demonstrat- 
ing abnormal presence of grape sugar. 

Treatment. Up to the present time the results from 
treatments generally resorted to have been of no avail. 
The disease is apparently incurable. In human beings 
fine results have recently been reported with what is 
known as the starvation treatment. Having noticed that 
the sugar content of the urine decreased when abstinence 
was enforced, Allen began to treat his cases of diabetes 
in human beings by starving them for variable periods 
of time. The results were good. A modification of the 
starvation treatment might be tried in horses. Feed 



92 SPECIAL EQUINE THERAPY 

rich in starches must be forbidden. Very light exercise 
in conjunction with the starvation gives better results 
than complete rest or idleness. 



LUPINOSIS 

Lupinosis occurs in sections where alfalfa is fed on 
pasture. The disease is quite common in the northwest- 
ern states. It results from the ingestion of lupine 
grasses containing lupinotoxin. 

Symptoms. Wliile there may be an initial constipa- 
tion, as claimed by some writers, the first symptom in 
my cases has always been violent purgation. The evacu- 
ations occur very frequently and at last are wholly fluid. 
This purgation may continue for several days, at the end 
of which time the horse appears greatly emaciated. There 
is now a wabbly gait, lack of coordination behind, and 
the horse stands about listlessly. The eye has a peculiar, 
bright, glassy stare. When the disease has been in ex- 
istence for three or four days the buccal mucous mem- 
brane becomes the seat of irregular ulcerated areas, vary- 
ing in size from that of a pea to a twenty-five cent piece. 
They have a tendency to spread and enlarge, and stub- 
bornly resist ordinary treatment. The horse retains 
some appetite throughout, but may not begin to eat nor- 
mally as long as the mouth is the seat of extensive ulcer- 
ated areas. The animals consume immense quantities of 
water if permitted to do so. In some cases there are also 
ulcerated areas on the skin of the lips, head or neck. 

In most cases edematous swellings appear in various 
parts of the body. The case may terminate in death in 
from a week to two weeks, during which time the purga- 
tion continues, and at the end of which time the horse is 
in a pitiable state of emaciation. Cases may recover 



LUPINOSIS 93 

completely under treatment, but convalescence is very 
slow. In some instances a stubborn polyuria supervenes. 

Symptoms that occur in some cases, but that are not 
seen in all cases, are icteric membranes and high tem- 
perature. In most cases the temperature is only elevated 
a few degrees Fahrenheit. Rare cases show some cere- 
bral disturbance, of which they give evidence by standing 
about, grinding their teeth. 

Treatment. The horse must be taken off pasture or, 
if in the stable, the lupine-content must be withheld from 
the ration. The symptom that gives the most concern 
in the greatest number of cases is the violent purgation. 
In the control of this I have had fine results from oil of 
eucalyptus. An ounce of oil of eucalyptus is given in 
capsule three times on the first day, twice the next day, 
and once a day for two days longer. The first dose or 
two is accompanied by a full dose of tincture of 
opium. 

The ulcerated condition in the mouth yields promptly 
to paintings of pure tincture of benzoin. Should any 
single ulcer prove more stubborn it may be lightly cau- 
terized with nitrate or silver, and the benzoin paintings 
then resumed. 

Hypodermic administration of medicines in eases of 
this disease frequently results in abscess formation and 
sloughing at the point of injection. Although the great- 
est care be taken regarding antisepsis and although the 
injected substance may not be irritating, such abscesses 
will occur frequently. 

Horses regain their former vitality very slowly after 
an attack of lupinosis. When the acute symptoms have 
been completely controlled the animal should be per- 
mitted to move about in an open lot or yard, and tonics 
may be administered. In some cases a recurrence of all 
the symptoms may take place, just when the horse seems 



94 SPECIAL EQUINE THERAPY 

about to improve. The same treatment must then be re- 
peated. 

The use of oil of eucalyptus was adopted as the most 
satisfactory treatment after I had failed to accomplish 
much good with various other medicaments. I have seen 
remarkable benefit in very grave cases of lupinosis from 
a single dose, especially when combined with opium. 



THROMBOTIC COLIC 95 

THROMBOTIC COLIC 

Obstruction of the mesenteric arteries by a species of 
Sclerostoma is a recognized clinical phenomenon in the 
horse. Thrombosis resulting as a consequence of such 
obstructions produces attacks of colic that are termed 
thrombotic colics. Cases of colic of this type are only 
reported when the attack terminates fatally, when post- 
mortem examination reveals the thrombotic vessels. 

That an obstruction in the mesenteric arteries will 
produce colicky pains is not a theory. Experiments per- 
formed on animals by ligating and limiting the blood 
supply in the mesentery have shown that two patholog- 
ical conditions will result, one of which is immediate and 
the other remote. The immediate result occurs within 
an hour or two after the blood supply has been cut off, 
and consists of violent peristaltic movements in that por- 
tion of the intestine from which the blood supply has been 
shut off. This violent peristalsis will continue until: 

1. The obstruction to the blood supply is removed; or 

2. The regional vessels assume the work of the ob 
structed artery; or 

3. The section of intestine is paralyzed. 

Under 1, there occurs an attack of "spasmodic" colic 
of moderate duration. 

Under 2, we see a prolonged siege of colicky pains and 
varying degrees of flatulence in the small intestines. 

Under 3, we see first what has just been said of 2, plus 
the grave developments of enteritis and peritonitis, ter- 
minating usually in death. 

The remote effect of obstruction in the mesenteric ar- 
teries is obliteration of the arteries and accompanying 
lack of tone in the section of gut formerly served by the 
obliterated artery. The result here, also, is colic. De- 
spite the fact that the manner in which colic can result 



96 SPECIAL EQUINE THERAPY 

from thrombosis of the mesenteric arteries is well under- 
stood, the diagnosis of such forms of colic is not easily 
made positive. Colic resulting from thrombotic mesen- 
teric arteries is fairly characteristic in its semeiology, yet 
the diagnosis can be made only problematically in clinics. 
Thrombotic colics are recurrent, always. 

Symptoms. There is practically only one form of colic 
resulting from thrombosis that can be diagnosed with any 
degree of positiveness, and that is the form which results 
under "1" mentioned above. A colic of this character 
comes on with no regard for digestive periods; it may 
come just before a feed, or it may come at midnight or 
any hour of the day. The symptoms hardly vary from 
those of a typical spasmodic colic, but there is always 
quite active peristaltic sounds to be heard in the small 
intestine. This active peristalsis in the absence of diar- 
rhoea may be said to be practically diagnostic of this 
form of colic. If, in addition to this, there is a history 
of previous similar attacks, colics occurring at variable 
hours from no apparent cause (such as change of feed, 
etc.), the diagnosis is made sure. 

This is the one form of colic in which exercise is justi- 
fied as part of the treatment. The horse, by being ridden 
or driven, so raises its blood pressure that it may have 
the effect of disintegrating the thrombus, or of hastening 
the establishment of a collateral circulation. Either ac- 
complishment terminates the attack of colic. This occurs 
in from a few minutes to a few hours. 

Medicinal treatment includes morphin, or tincture of 
opium, and other anodyne agents. Cathartics are contra- 
indicated in this type of thrombotic colic. 

When the obstruction is not removed promptly, or if 
collateral circulation does not become rapidly established 
in the neighboring vessels, the attack of colic is pro- 
longed. At the end of four or five hours a degree of 



THROMBOTIC COLIC 97 

flatulence has been added to the clinical picture, and 
there is now either a diarrhoea or frequent evacuations of 
feces of normal consistency. At times there is a trace of 
bloody mucus mixed with or covering these. 

In treating the case now volatile oils may be admin- 
istered internally, and anodyne or analgesic agents which 
are used should be such as do not constipate. The attack 
may yet terminate favorably at the end of a few hours, 
or it may hang on for several days. 

If the thrombus does not yield, or if the regional ves- 
sels do not carry the load for the thrombotic vessel, the 
case becomes serious. We then get either intestinal 
paralj^sis, or enteritis. When paralysis of a section of 
the intestine occurs the symptoms suddenly change. The 
horse ceases to exhibit signs of acute pain, but gives evi- 
dence, on the other hand, of dull, drowsy uneasiness. 
Flatulence increases, and muscular tremors and twitch- 
ings occur. Still later there are staggering, high tem- 
perature, filiform pulse, and fetid evacuations. Death 
comes at the end of twelve to eighteen hours. 

Treatment in this stage can only be symptomatic. 
Symptoms of enteritis are well known. 

Cases of colic that occur from the remote effects of 
thrombosis (atonic sections of the small intestine) are 
usually prolonged, atypical, recurrent colics. Varying 
degrees of pain are exhibited by the patient, and there 
are at times some evidences of flatulence. The attacks 
are of short duration. 

Attacks of colic occurring in horses repeatedly with- 
out cause are always to be suspected as being due to 
thrombosis of the mesenteric arteries. 

The prognosis is doubtful in all cases of colic resulting 
from thrombosis in the mesenteric arteries. While a 
horse may survive attack after attack, it is impossible to 
forecast what the termination will be in any particular 



98 SPECIAL EQUINE THERAPY 

attack. While the prognosis is always doubtful, it does 
not become grave or unfavorable until there is evidence 
that the intestinal disturbance has been transformed 
from a functional derangement to a structural pathologic 
process. 



DISEASES OF THE HEART 99 

DISEASES OF THE HEART 

Veterinarians, as a rule, do not find diseases of the 
heart of sufficient importance to give them much study. 
When a distinct heart lesion is encountered in horses 
there is really only one important point in the diagnosis, 
and that concerns the fact whether the lesion is functional 
or structural. A structural heart lesion in horses means, 
almost in every instance, that the horse has become un- 
serviceable. A possible exception to this statement might 
be found in a case where a compensatory hypertrophy 
had occurred. From a practical standpoint it is a very 
reasonable statement to say that heart diseases in horses, 
accompanied by noteworthy organic lesions, are never 
worthy of treatment. 

In the interests of the client the best practitioner under 
such conditions is the one who can be relied upon to ap- 
preciate this at the earliest possible moment, and to its 
fullest extent. In no other class of diseases is this so 
true as in diseases of the heart. "While it is many times 
not a very difficult matter to so handle the case that the 
horse will apparently regain a fair semblance of health, 
it is almost a foregone conclusion that the symptoms will 
return as soon as the horse resumes its regular duties, if 
the heart substance has suffered structural damage. 
Luckily, heart diseases per se are quite rare in the horse, 
and they may almost be said to occur only as a sequel to 
some acute infectious disease. 

Functional heart diseases are always transient in 
horses, and in most instances disappear without treat- 
ment. The evidences of organic heart lesions are 
chiefly : 

1. Persistence of the symptoms. 

2. Involvement of other organs in the symptom com- 
plex, especially of the kidneys. 



100 SPECIAL EQUINE THERAPY 

3. Edematous swellings in the subcutaneous tissues of 
dependent parts. 

4. Recurrence of the symptoms when the animal re- 
sumes work, although a cure may have been simulated 
by their disappearance after the initial sickness. 

Whenever two or more of these features become identi- 
fied with evidences of a heart lesion the disease may 
with certainty be classed as organic. The prognosis is 
then always unfavorable. 

Organic heart disease occurring as a sequel to infec- 
tious diseases is not nearly so common as formerly ; since 
the use of biologic therapeutics has been quite gener- 
ally adopted in the treatment of infectious fevers, and 
the use of depressants is less popular, the heart is spared. 

Although a few authors have given the consideration 
of diseases of the heart considerable space, it can be said 
without fear of contradiction that the average practi- 
tioner gives such discussions scant attention. This is not 
so because of lack of appreciation on the part of prac- 
titioners, but only because diseases of the heart are really 
of minor importance in the average practice. When a 
case does occur the practitioner usually finds little trouble 
in recognizing it, although in most instances no great 
effort is made along curative lines. The performance 
of even the most ordinary work expected of horses is of 
such a strenuous character that the results following the 
treatment of organic heart lesions usually fall short of 
the requirements. In veterinary practice it is oftentimes 
a case of "service or death;" sentiment plays a very 
small part in our branch of medicine and, possibly except- 
ing canine and feline patients, the practitioner's results 
are nearly always judged on a commercial basis. 



AZOTURIA 101 

AZOTURIA 

No one disease of horses has been the subject of so many 
theories, theoretical treatments and hypothetical sugges- 
tions as this one. It is doubtful whether, out of the thou- 
sands of veterinarians in practice in America, fifty could 
be found who agree to any extent on the pathology and 
treatment of azoturia. 

Probably one reason for this is the great variety of 
forms in which azoturia attacks horses. 

Azoturia in the city horse, for instance, differs con- 
siderably from the azoturia seen in the country horse. 
The city horse develops a more severe, acute and, usually, 
rapidly fatal form. 

Cases seen in the country are of a milder type, and do 
not run such a rapid hyperacute course. 

This, then, would explain to a certain extent the dis- 
agreement among veterinarians in regard to several 
points of importance concerning this disease. 

The fact that azoturia presents different clinical pic- 
tures under different circumstances, environment, local- 
ity, feeding customs, breeds and individuals, further 
explains why veterinarians are not agreed on its fea- 
tures. 

Lastly, all argument is explained away by the fact that 
no one has so far succeeded in demonstrating satisfac- 
torily what azoturia really is. I refer, of course, to its 
identity from the standpoint of pathology. From the 
standpoint of the clinician, the diagnostician, the subject 
is quite clear. Assume that your horse has azoturia. 
Call in a hundred veterinarians ; or two hundred, if you 
wish. Each and every one of them, without exception, 
will recognize the condition and make exactly the same 
diagnosis — azoturia ! 

But question them in regard to the pathology of azo- 



102 SPECIAL EQUINE THERAPY 

turia! Probably not ten of them would hold the same 
belief. 

And were you to get from each of these veterinarians a 
prescription for the treatment of this case of azoturia, 
you would no doubt have several dozen different treat- 
ments. 

It does not take a very learned man to arrive at the 
conclusion that, granting the above is true, azoturia must, 
indeed, be a formidable foe, both of the veterinarian and 
his patient. 

As every veterinarian is familiar with them it is un- 
necessary to discuss at any great length the symptoms 
and diagnosis of azoturia. I shall therefore confine my 
remarks to some of the vagaries of the disease, its probable 
pathology, and its treatment. 

Briefly, azoturia is an acute disease of horses, charac- 
terized by great nervous excitement in its early stages 
when it occurs in a typical form, and terminating in com- 
plete prostration of the subject attacked. Secondary 
clinical phenomena are hematuria, or rather hemoglo- 
binemia, delirium, and prolonged decubitus. Death is 
either sudden, coming at the end of a few days, or results 
after variable periods of time from complications or the 
effects of decubitus. 

It attacks young, thriving horses as a rule, though occa- 
sionally aged horses are affected. 

The disease is a cold weather disease, but odd cases are 
seen at all seasons of the year. The greatest number of 
cases come during the winter months, from November to 
May, and an attack most frequently follows a short period 
of idleness. Prom one to three days of idleness, on reg- 
ular rations, is a predisposing factor. Longer periods 
of idleness are not usually followed by an attack of azo- 
turia. The foregoing remarks have reference to typical 
cases of azoturia. 



AZOTURIA 103 

To record in detail the various atypical forms and 
changed clinical pictures of this disease would be the work 
of a lifetime. We shall, however, attempt a review of the 
more important features presented in atypical attacks, 
and shall begin the discussion by noting the diiferences 
between azoturia cases in city horses and in farm horses. 

Azoturia as seen in horses by the city practitioner, is, 
as a rule, a more serious condition than that which the 
country practitioner sees in his patients. City horses 
develop azoturia nearly always in a typical form. The 
attack comes, is barely noted before the horse goes down, 
and death comes nearly as quickly, after a day or two. 

The country horse develops an attack in a more lei- 
surely manner. In over half the cases seen in the country 
the disease gives fair notice that it is on the way. There 
is, first, lagging, possibly some perspiration; then, if 
the animal is stopped, symptoms are seen which point 
towards acute indigestion. If properly handled, the con- 
dition stops here, and the horse is again in good health 
after the lapse of a few hours. Country horses that go 
down with azoturia have usually gone down because the 
driver lacked the good sense to stop the animal as soon 
as he noted that it was not well. But even cases of azo- 
turia in the height of their development in country 
horses, when the animal is down, are milder in form than 
the same cases would be in city horses. 

The explanation probably lies in the more concentrated 
feed upon which the city horse lives, and in the more 
strenuous existence he is forced to lead. Country azo- 
turia cases that receive ordinary care and treatment 
while the animal is yet standing will make a complete 
recovery in a few hours ninety-eight times out of a hun- 
dred. The city practitioner does not find it so. Many 
of the cases to which he is called while the horse is yet on 
its feet go down in spite of the best care and treatment. 



104 SPECIAL EQUINE THERAPY 

The cases he sees before the animal goes down are not 
many at the most. 

Here we have the explanation for some of the beliefs 
in the treatment of this disease. 

We can dispose of the discussion of the part which the 
city horse plays in this disease by saying; that the attacks 
are nearly always typical, that they are more grave than 
in country horses, and that the mortality is much higher. 

Aside from the less acute character of azoturia in coun- 
try horses, it presents other vagaries. The country practi- 
tioner sees more atypical cases of this disease than typical. 

Probably the most common cases are those in which the 
horse is standing up when the doctor arrives; he shows 
signs of abdominal pain, looks around towards his sides. 
He may be breathing a trifle fast ; the nostrils are dilated. 
There is a slight trembling of some muscle groups, but so 
slight that unless the veterinarian suspects azoturia he 
will not notice it. Sometimes, but not very often, there is 
some swelling in the gluteal region. Now and then a 
case shows swelling in the shoulder muscles. 

If the catheter is used, the urine that is withdrawn 
shows darker than normal ; occasionally, in these cases, it 
is typical coffee colored, but more often it is just a trifle 
darker than normal. 

Properly handled, most of these cases are again nor- 
mal within a few hours, except that in many of them 
swelling appears after eight or ten hours in the gluteal 
region, and the urine is not yet clear, or is even of a 
more typical azoturia color than it was in the beginning. 
This proves the diagnosis. 

Out of a hundred cases of the character described 
above, a single one may become progressively worse until 
complete prostration and a fully developed case is estab- 
lished. The remaining ninety-nine cases will make an 
uneventful recovery within a few hours' time. 



AZOTURIA 105 

Another atypical form of azoturia common in 
country practice is that form affecting only one hind 
limb. 

In these there is apparently acute pain; the animal is 
very uneasy, may lie down, and again rises to its feet 
with considerable difficulty. There is marked fullness in 
the gluteal region of the affected limb and trembling of 
the muscles in the crural region. The limb does not seem 
able to support its share of the bodily weight, and the 
animal works itself into a state of extreme exhaustion in 
its efforts to stand normally. While a goodly number of 
these cases go down eventually, few of them succumb. A 
few days of judicious handling restores the animal to 
usefulness. 

A form of azoturia is often seen in country horses 
affecting chiefly the front limbs. There is in these cases 
immense tumefaction of the shoulder region, and the , 
brachial m.uscles. This swelling in many instances per- 
sists for several days, although all other evidence of the 
disease may disappear within a few hours after its 
initiation. 

Of all the atypical forms of azoturia, the one which 
causes the practitioner the most anxiety is that form in 
which the predominating symptoms are of a nervous char- 
acter. Although the animal is standing up and the usual 
azoturia symptoms are mild the horse appears to be suf- 
fering from extremely heightened nervous tension. Con- 
stant shifting about from one leg to the other is gone 
through; the animal repeatedly backs up or attempts to 
move forward ; the head is kept going from side to side, 
or is jerked nervously upward and downward. In this 
form there is frequently a degree of trismus, making it 
almost impossible to administer medicaments orally. This 
form of the disease frequently assumes a very serious 
course. The constant moving about tends to aggravate 



106 SPECIAL EQUINE THERAPY 

the condition, and not a few of these cases ultimately go 
down. 

An atypical form of azoturia which is not so common 
is a form affecting isolated muscle groups. One crural 
group, or one brachial group only, may be involved, show- 
ing marked swelling and extreme hardness. The animal 
exhibits no other symptoms except the full, rapid, tense 
pulse, and a "dopey" or sluggish countenance. The 
urine, when drawn or voided, confirms the diagnosis of 
azoturia by its consistency and coffee-like color. These 
cases, while not severe or serious, occasionally prove stub- 
born under treatment. 

For the purposes of identification and proper treat- 
ment we should classify the various forms of azoturia as 
follows : 

First. Cases during the initial stage of which symp- 
toms of digestive organs predominate. 

Second. Cases during the initial stage of which mus- 
cular symptoms predominate. 

Third. Cases during the initial stage of which nervous 
symptoms predominate. 

A careful adjustment of this classification to any given 
case in its early stages and the administration of adjunct- 
ive treatment on the basis of this classification will do 
much towards reducing the hazard, or the tendency, 
towards an aggravation. 

Azoturia in mares seems to run a more mild and favor- 
able course than it does in geldings.* 

* The reader is reminded that the conclusions and averages 
arrived at in this thesis are not only those gained by the author 
in his own experience, but they cover the reports and opinions of 
hundreds of veterinarians obtained during a period of four or five 
years from all parts of the United States and Canada, by the 
author in his capacity of Veterinary Director for the Azolysin 
Company, manufacturers of the Azolysin treatment for azoturia. 



AZOTURIA 107 

The classification jnst made is only applicable in the 
early stages or in the mild cases that do not go down. 
Once the patient is permanently prone ("cZowtt" ex- 
presses it better than anything), we have azoturia per se, 
and no classification of predominating symptoms is 
required. 

We noAV arrive at the discussion of that part of the 
subject of azoturia which, aside from the treatment of 
the disease, is of the greatest interest to the practitioner, 
namely, its pathology. 

In the beginning of this chapter I stated that so far 
no one had satisfactorily demonstrated just what azo- 
turia really is from a pathological standpoint. I now 
desire to modify this statement in so far as my own 
satisfaction is concerned. I am thoroughly satisfied that 
the theory which I here present is rational, sane and 
practical. 

This theory was published in the October, 1912, issue 
of the American Journal of Veterinary Medicine under 
the signature of the writer and Dr. R. "W. McCracken, a 
physician. As far as we have been able to learn the 
theory, which we named "the mechanical theory of azo- 
turia, ' ' is entirely original with us, and up to the present 
moment has not been successfully challenged or exploded. 
Upon this theory was based the "azolysin treatment," 
a treatment also original with us, and one which probably 
has more recoveries to its credit than all other forms of 
treatment combined. In my opinion the theory that has 
the least ground for existence is the theory based on a 
toxemia. How anyone can believe that a toxemia of a 
nature so active that it can, in a few minutes, wholly 
incapacitate a horse otherwise in the "pink" of condition, 
and that will suddenly cease its action when the horse is 
properly handled (as we have frequently seen in eases 
quite well developed, with no direct treatment aimed at a 



108 SPECIAL EQUINE THERAPY 

toxic poison, often nothing more than absolute quiet) 
can exist is beyond my comprehension. 

I can appreciate a form of toxemia violent and active 
enough to bring on an attack of azoturia ; but my entire 
professional judgment rebels against the acceptance of 
the second factor, namely, the spontaneous cessation of 
activity of a toxemia, or a toxin, so active. We cannot 
believe in the theory of a toxemia as the excitant in the 
disease if we have thoroughly mastered the fundamentals 
of certain branches in the study of veterinary science ! 
And still less can we accept this theory when we fully 
understand the disease, and when we endeavor to make 
the theory fit the condition as we know it. 

The "mechanical theory" elaborated by us has not 
been born in idle speculation. It is the result of a care- 
ful weeding out of other theories, and diligent study of 
azoturia from a clinical standpoint. The theory is the 
result of the interlocking understanding of a theory- 
forming, finely-tuned physician's brain and the more 
materialistic, hard-headed, veterinary judgment. 

I give it here as it appeared in the issue of the Journal 
already mentioned. 

"Our theory is, and our success with the treatment 
based on this theory proves its soundness, that the con- 
dition is a mechanical one entirely, if we may use the 
word in this sense. "We mean by this that toxins, en- 
zymes, bacteria, ferments or extraneous forces of any 
nature whatsoever have no hand in the production of this 
disease. 

"The theory which nearly every veterinarian with 
whom we discussed this suggested as the most plausible 
was that azoturia is a toxemia. In the summing up given 
below we make special mention of this to show how the 
symptoms in certain stages of this disease absolutely 
exclude toxemia as a cause of azoturia. To come to the 



AZOTURIA 109 

point, we believe that the condition in azoturia is first 
a viscosity of the blood; later, if the condition does not 
abate, genuine clotting or thrombosis in the vessels of the 
parts involved. Death occurs either early as the result 
of embolism, or late from decubitus and its accompani- 
ments. Carefully follow the form below, in which we 
work out the theory. 

"1. A horse at rest a number of days on full rations. 

"2. A modified atony of the muscular coats of the ves- 
sels results, accompanied by a hyper-nitrogenous condi- 
tion of the blood and internal secretions. 

"3. In adverse ratio to this atony is the accelerated 
tone of nervous elements, causing the horse to 'feel 
good,' as it is commonly expressed. 

"4. When this horse is put to work he is keyed up to 
the highest pitch as regards volition; in other words, 
he has ambition forced upon him by the heightened tone 
of his nervous system. (Here could be inserted the rea- 
son why the disease does not occur or is so rare in 
summer. ) 

''5. Responding to this stimulation the cardiac action 
as a result of a few minutes' exercise assumes the force 
which it would, under normal conditions, attain only at 
the end of the most strenuous exertion, at running or 
severe pulling in harness. This does not produce objec- 
tive tachycardia because of the flaccid condition of the 
muscular apparatus of the vessels. 

"6. From this atony or flaccidity the vessels in the 
extremities are the last to recover; in fact, if the horse 
is not stopped at once they (the vessels) do not recover. 
Gravity plays a slight part here. 

''7. Soon there is a real blocking of the circulation in 
these parts. 

"8. The large muscles in the region attempt to assist 
the vasoconstrictors; they contract in a firm spasm 



110 SPECIAL EQUINE THERAPY 

around the vessels, thus bringing about the swelling in 
the gluteal or the brachial region. 

"9. From viscosity to thrombosis is a short step. The 
patient goes down, and if thrombosis has occurred and 
the clot is not fixed, the patient is dead in a few days from 
embolism, dying with symptoms of apoplexy. 

"10. When the condition is less severe, halting at 
viscosity, the patient recovers or lingers along and finally 
dies from the various results of prolonged decubitus. (A 
good example of a very mild ease of azoturia we expe- 
rience when we sit a long time in one position and a leg 
or an arm 'goes to sleep.') 

' ' Theoretical proof of our theory and proof of the abso- 
lute falsity of the theory of a toxemia lies in the fol- 
lowing : 

' ' If this horse is exercised very mildly and then allowed 
to rest for a half hour before he is put to work, thus 
allowing the muscular tone of the vessels to regenerate 
itself preparatory to prolonged exertion, the disease does 
not occur, 

"We will go still farther and say the horse, instead 
of being first exercised, is at once put to work and is 
attacked by the disease, but the driver stops him as soon 
as he sees the symptoms coming on. We all know that 
this horse will not go down and will recover with no fur- 
ther treatment than absolute rest. This, because it gives 
the circulatory muscular apparatus an opportunity to 
revive and fortify itself before the vessels are pumped so 
full of blood that absolute, or practically absolute, stasis 
occurs, ' ' 

The greater portion of this theory is amply substan- 
tiated by the clinical manifestations of the disease. This 
is more than can be said of any other theory applied to 
it in the past. Parts of it could be a little finer drawn, 
and still remain sound ; on the whole, it meets with the 



AZOTURIA 111 

approval of the general practitioner more readily than 
other theories. 

The fact that the treatment which was based upon it 
has proved remarkably successful is the best evidence 
that this theory has merit. Accepting this theory as our 
basis we searched about for an agent that would prevent 
coagulation and that would, if it were possible, bring 
about a resolution of blood already coagulated. After 
much digging in textbooks on physiology, and after a 
series of experiments, we chose oxalic acid, believing that 
after ingestion it would rapidly form oxalates of potas- 
sium in sufficient amount to serve our purpose. The dose 
which we found most satisfactory for repetition was four 
grains. 

Oxalic acid is an active agent, and while this dose 
may appear small, it is sufficient for all practical ends 
when repeated hourly. 

This, then, is the active principle of azolysin — oxalic 
acid. 

For business motives several other ingredients were 
added to azolysin while it was on the market as a secret 
preparation. 

From reports gathered over a period of four or five 
years we have evidence that this oxalic acid treatment 
will save over eighty per cent of the bad form — cases in 
which the horse is down. Veterinarians who used azoly- 
sin, as made by the Azolysin Company, did not use the 
treatment in mild cases ; it was too expensive. For this 
reason I do not hesitate to say that the percentage of 
recoveries will be over ninety per cent when the treat- 
ment is used as a routine treatment. 

While oxalic acid alone will save many cases, I would 
recommend the use of symptomatic treatment in eon- 
junction. 

Cases showing a predominating nervous trend should 



112 SPECIAL EQUINE THERAPY 

have bromides, gelsemium or chloral. Dr. E. L. Quitman 
advises lobelin for the nervous symptoms. Cases showing 
symptoms of digestive disturbance should have salicylic 
acid, carminatives, and evacuants. 

Cases with immense swelling of certain muscle groups 
should have massage. It is well to start the treatment 
of all severe cases with a purgative. Water should 
be given in abundance, drenching the patient with 
several quarts every few hours if he refuses to drink it 
freely. 

The oxalic acid should be administered in four-grain 
doses every hour until seven or eight doses have been 
given. It must be given highly diluted with water to 
prevent any local action on the mucous membranes. It 
is not caustic, but has a softening or degenerative effect 
in concentrated solutions. After seven or eight hourly 
exhibitions, it should be given every two or three hours. 
In exceptionally grave cases the first dose or two may 
be doubled. The catheter may be used for the purpose 
of emptying the bladder in the early stages. Later it is 
neither necessary nor beneficial. 

Cases which are down should not be molested or urged 
to get up before the lapse of at least eighteen hours, unless 
they make voluntary attempts to arise. In raising a 
horse, down with azoturia, two good men lifting at the tail 
can accomplish all the aid needed. If the animal is not 
able to get up with this assistance its condition has not 
yet improved sufficiently to make the standing position 
desirable. A few strokes with a whip may be required 
in some cases to induce the animal to make a strong 
attempt to arise. 

The use of slings is not recommended. The practi- 
tioner who uses slings for the purpose of raising up 
horses, down with azoturia, should lose his right to prac- 
tice; he understands neither the disease nor the horse. 



AZOTURIA 113 

I have personally seen a number of deaths directly 
attributable to the use of slings in this disease. 

If the patient remains down for several hours or longer 
he should be turned over every two or three hours. Grain 
should be fed sparingly, if at all. 

All cases terminating in recovery should have a course 
of diuretic and alterative treatment extending over a 
short period of time, say four or five days. Local or 
regional applications in the form of hot packs may be 
beneficial in cases showing great muscle swelling. Warm 
quarters and quiet surroundings aid all forms of treat- 
ment. 

In concluding the discussion of the treatment of azo- 
turia I wish to remark that I do not wish to give the 
impression that the oxalic acid treatment is perfect. As 
one eastern veterinarian, who has used the treatment for 
four years in a large practice, says: "We get better 
results with this treatment than with any other, but it is a 
long way from being a specific." 

Neither do I wish to give the impression that this is 
the best treatment that we will ever find for this disease. 
But I do believe that any improvement in the treatment 
must come along the lines of the "mechanical theory" 
of the pathology of the disease, or of a modification of 
this theory. Possibly the mechanical theory is only on 
the verge of truth and soundness. However, it is the 
most reasonable, the most sane and sound theory yet 
expounded for azoturia; and the fact that it has bred a 
treatment of such merit as the oxalic acid, or ' ' azolysin ' ' 
treatment, is good enough evidence to satisfy the general 
practitioner. 

Possibly, at some time in the near future some labora- 
tory expert will give us an agent that will more satis- 
factorily perform the work which we now rely upon 
oxalic acid to do. Someone may even find a means of 



114 SPECIAL EQUINE THERAPY 

isolating and making synthetically the exact agent re- 
quired. Until this happens, however, most of us will rely 
on oxalic acid for effect in severe cases of azoturia. A 
factor very much in favor of the oxalic acid treatment is 
its inexpensiveness. Another is its simplicity, and the 
promptness with which it accomplishes results in the 
great majority of cases. In this regard it is like any other 
treatment; the better one becomes acquainted with the 
treatment, the better will be the results. 

An important factor in the successful treatment of 
azoturia with oxalic acid lies in beginning the treatment 
as early in the attack as possible. If the horse has been 
down more than twelve hours the treatment cannot 
accomplish much. 

Prognosis. I can point to no particular clinical signs 
which can be relied upon to forecast the termination in 
well-marked cases of azoturia. Oftentimes the case which 
appears to be most violent in character makes a rapid, 
uneventful recovery. On the other hand, cases are fre- 
quently seen which, in the beginning of the attack, appear 
mild and ordinary, and yet terminate fatally. 

The color of the urine cannot be relied upon as a prog- 
nosticating factor. With the oxalic acid treatment the 
prognosis is very unfavorable if the horse does not get 
up within forty-eight hours after the treatment is begun. 
Cases in which marked delirium persists in spite of treat- 
ment are usually fatal cases. 

Cases that remain down longer than forty-eight hours 
do not usually make a complete recovery; most of them 
suffer later from one or more of the sequelae common to 
this affection. 

Sequelm. Attacks of azoturia, mild in character, dur- 
ing which the horse remains on its feet, rarely leave after- 
effects of any consequence. Now and then, after a mild 
attack, a certain stiffness or awkwardness remains in the 



AZOTURIA 115 

members affected. This usually passes off in a short time 
without treatment of any kind. 

In grave attacks, during which the horse has been down 
for a number of days, the most common after-effects are 
bed sores. These come on the points of the hips and 
other prominent places. Some of these sores are very 
resistant to treatment, and they may leave permanent 
scars. They are commonly treated with antiseptics and 
astringent lotions, healing powders or ointments. In 
obstinate cases an occasional swabbing with a caustic 
solution of silver nitrate will hasten healing. Those hav- 
ing centers of dead or gangrenous tissue should first be 
curetted. 

Another common sequel of azoturia takes the form of 
muscular atrophy. This sequel is sometimes seen after 
cases that were not severe by any means. The degree of 
atrophy varies from a slight flattening of the muscles to 
an almost complete disappearance of the muscle involved. 
Most commonly it is the gluteal region or the crural 
group ; sometimes both. This atrophy is very stubborn 
under treatment and often requires several months for its 
correction. I have seen no particular or noteworthy bene- 
fit from any form of treatment. Now and then a certain 
case will respond marvelously under one form of han- 
dling; when another case is given the same treatment 
nothing whatever is seen of a beneficial result. 

The usual treatment for this sequel consists of setons, 
blisters, massage, injections of strychnin or of irritant 
agents, tonics, alteratives, and occasionally actual 
cautery. 

In my experience one is as good as another. I have 
seen a few cases in which this atrophy remained perma- 
nently. After several weeks of hospital treatment the 
animals were turned out to grass for several months. On 
their return to the stable at the end of this period not a 



116 SPECIAL EQUINE THERAPY 

particle of improvement had been made. After another 
month or so of treatment the animals were in each case 
destroyed. 

Lack of coordination in the posterior extremities is 
another rather frequent after-effect of azoturia. This 
ranges from a slight awkwardness in turning or backing, 
to a ridiculous wabbling in all gaits. It makes its appear- 
ance from a few weeks to a month after recovery from 
the attack of azoturia. 

Prolonged courses of potassium iodid treatment will 
effect a cure in a good many of these cases. A somewhat 
rare, but noteworthy, sequel to azoturia is a relapse. 
After the animal has apparently recovered from an 
attack, another attack is ushered in. As I have already 
remarked, this is a rare occurrence ; it has happened once 
or twice in my practice, and other practitioners have 
reported it also. 

A few years ago I had a patient that developed an 
attack of azoturia several times each year. This animal, 
a mare, was down for two or three days on several occa- 
sions with a well-marked case of azoturia, and on at least 
one occasion her condition was very grave. She made a 
complete recovery after at least four attacks to my own 
knowledge. She was then sold to a farmer a few miles 
away, and had no more attacks for at least two years, 
after which I lost sight of her. In one instance this mare 
apparently had recovered entirely from an attack. She 
got up, was normal in every respect for nearly twenty- 
four hours, and then suddenly went down again. She 
remained down for nearly two days with all symptoms 
of azoturia well marked. At the end of the second day 
she got up and made a rapid recovery. None of the 
attacks from which this mare suffered were followed by 
after-effects of any kind. 

It is my opinion that the treatment used in combating 



AZOTURIA 117 

an attack of azoturia has considerable bearing on whether 
sequelae develop or not. Since I have been using the 
oxalic acid treatment I have seen very few cases that 
developed serious or permanent sequelas. The recovery 
under this treatment is as nearly complete as could be 
desired. 



118 SPECIAL EQUINE THERAPY 

TRANSIENT CRURAL PARALYSIS 

In this, we have a condition which is very confusing 
to the practitioner who has not had previous acquaint- 
ance wdth it. 

It occurs almost always in young horses, usually dur- 
ing the fourth or fifth year. It makes its appearance 
precipitately, and as a rule disappears within a number 
of hours after its development. It is important chiefly 
from the viewpoint of prognosis. 

The affected limb is held in a limp, flaccid attitude ; 
the hock is extended to the limit, the ankle fluxed com- 
pletely. In moving about the animal drags the leg 
loosely, the anterior face of the ankle touching the 
ground. The paralysis apparently includes the motor 
nerves only ; sensation is not impaired in the parts. 

The condition must be differentiated from the fol- 
lowing affections: 

1. Cramp. 

2. Rupture of the flexor metatarsi. 
8. True crural paralysis. 

It is differentiated from cramp by the loose, flaccid 
condition of the muscles. A sudden shock, such as a 
stroke with a whip, will dispel cramp. Not so with this 
condition. In cramp, the entire limb is held rigid. 

From rupture of the flexar metatarsi it is differentiated 
by the absence of trauma, lack of swelling and soreness 
on palpation in the region of the tendon of the flexor. 

True crural paralysis differs from the condition under 
discussion in that it makes its appearance gradually, or 
else follows injuries sustained in falling, in being cast, or 
from other noted accidents. A history of this nature can 
usually be obtained from owners or attendants in cases 
of true crural paralysis. A history that now and then 
goes with a case of transient crural paralysis is that the 



CRURAL PARALYSIS 119 

patient has for some time been a bit "stringy." Evi- 
dence of stringhalt has especially been noted in horses 
when they are first started in harness in the morning. 

As has already been said, the condition is important 
only from the standpoint of prognosis. When presented 
for the veterinarian 's attention, a case of transient crural 
paralysis appears quite formidable. From the appear- 
ance of the patient a grave prognosis seems necessary to 
the inexperienced. Rarely does this condition persist 
longer than four or five hours. Even without treatment 
of any kind most cases terminate favorably in a few 
hours. Recovery is spontaneous, almost instantaneous, 
and complete. However, recurrence is common. Some 
horses have an attack of transient crural paralysis every 
few weeks or months. In some instances each attack is 
more marked and persists for a longer period of time 
than previous attacks. The stringhalt symptom is also 
aggravated. 

The repetition of attacks abates with maturity. After 
the sixth year few cases are seen. In horses developing 
repeated attacks of this affection treatment aimed at a 
constitutional disturbance is valuable. Fowler's solution 
of arsenic, iron, or iodides may be tried in turn. In my 
experience iodides gave the best results. Stimulating 
liniments, blisters, and massage may be used locally. 

The pathology of this condition is not known. No 
doubt it is due to a functional aberration in one of the 
body glands concerned in controlling growth. Possibly 
the thyroid gland is involved. From the salutary effect 
obtained from the administration of potassium iodid in 
recurrent attacks one may suspect the thyroid gland is 
affected in these cases. 



120 SPECIAL EQUINE TPIERAPY 

LYMPHANGITIS 

We will discuss in this article that form of lymphan- 
gitis which, despite modern bacteriologic thought, is best 
described as an idiopathic lymphangitis. We choose to 
confine our discussion to this form of the disease because, 
in our opinion, all other forms are preceded by this one. 
Further, this is the most common form of lymphangitis. 
We do not agree with those over-enthusiastic bacteriolo- 
gists who ascribe all attacks of lymphangitis in horses to 
infection following an injury. In a practice covering a 
considerable period of time, we have not been able to 
adopt this view; the clinical evidence has not been suffi- 
ciently ample to demonstrate the correctness of such a 
theory. On the other hand, so markedly contrary to this 
theory is the clinical evidence that we consider the old 
name of "Monday morning sickness" most appropriate. 
Clinically, lymphangitis in horses is, in most instances, 
a functional disturbance, primarily innocent of bac- 
teriologic taint. When we refer to lymphangitis in vet- 
erinary subjects, we mean, as a rule, that typical form 
of lymphangitis affecting a pelvic limb. While lymphan- 
gitis, or inflammatory processes in lymphatic vessels, is 
possible in any part of the body, the term lymphangitis in 
veterinary literature has come to stand almost wholly for 
that form affecting a pelvic limb. In rare instances lym- 
phangitis, or a generalized congestion and inflammation 
of the lymphatics, has been reported as occurring in a 
pectoral limb. 

While lymphangitis is somewhat more common in 
young horses, it occurs with almost equal frequency in 
mature or aged horses that are in thriving condition. Un- 
thrifty, weakly animals are not often affected by this 
disease in any of its forms. Animals heavily fed on grain 
with an under-proportioned share of work are predis- 



LYMPHANGITIS 121 

posed to lymphangitis to a lesser extent than heavily fed 
horses that are also heavily worked. An abrupt cessation 
of activity in the latter, occasional holidays, may at any 
time precipitate an attack of lymphangitis. 

Symptoms. Lymphangitis in most cases makes its 
appearance without particular premonitory signs. In 
some cases there may be a rigor which ushers in the 
attack. Most frequently, however, the disease makes its 
appearance with speed minus stormy symptoms. Follow- 
ing upon a day or two of rest the horse is found some 
morning to have a considerable enlargement of one limb. 
The swelling extends from the groin to the hoof, is pain- 
ful and hot, and has a line of demarcation near the body. 
The animal refuses its feed and has a body temperature 
of from 103° F. to 106° F. There is usually some con- 
stipation. 

The swelling is quite evenly firm, except near the line 
of demarcation, where it is more "doughy" ; in the inter- 
nal aspect of the thigh this ' ' doughy ' ' consistency of the 
swelling is most marked. The swelling above the hoof 
may be of such proportions that the coronary region 
appears to extend anteriorly over the hoof for several 
inches. 

As a result of infection with pyogenic bacteria, abscess 
formation may occur at various points on the affected 
limb. Mild cases of lymphangitis recover spontaneously. 
In many cases, however, some enlargement remains in the 
limb permanently. Well marked cases require careful 
and judicious treatment. Recurrent attacks of lympan- 
gitis are not rare. One patient in our practice has had 
about six attacks within two or three years. Repeated 
attacks of lymphangitis may ultimately leave the affected 
limb permanently enlarged. 

Treatment. The treatment of lymphangitis, in the 
idiopathic form, should include: 



122 SPECIAL EQUINE THERAPY 

1. Depleting internal medication. 

2. Local or regional applications. 

3. Prophylactic bacterin therapy. 

4. Dietary regulations. 

1. Despite recent improvement in the line of hypo- 
dermatic medication, for cathartic effect we have found 
nothing that has a more satisfying effect in cases of lym- 
phangitis than aloes. From an ounce to an ounce and a 
half in bolus form, is the ideal cathartic in these cases. 
For the best effect the bolus should be hard. Powdered 
aloes given loosely in capsule is not satisfactory ; neither 
have we found the effect of aloin nearly so satisfactory 
as that of aloes. As soon as the cathartic effect of the 
aloes is established we begin the administration of small 
doses of salol or sulpho-carbolates compound. This ad- 
ministration is kept up until the case assumes a favorable 
aspect, usually four days. If the appetite is entirely 
absent, an occasional dose of bitter tonics may be given. 

2. Local applications consist of prolonged fomentation, 
at least twenty minutes out of each hour. The water 
must be as hot as the patient will bear it. These fomen- 
tations are followed by the local application of solutions 
of lead acetate, or other astringents. 

3. Every case of lymphangitis should receive a prophy- 
lactic dose of mixed bacterins to forestall abscess forma- 
tion. 

4. Dietary measures consist of total abstinence from 
grain. Hay may be eaten freely. Water may be given 
ad Uhitum. 

During the first four or five days the patient must not 
be moved ; absolute rest is imperative. At the end of this 
time, if considerable improvement in the general condi- 
tion is noted, the animal may take a few steps. The 
am-ount of exercise is to be gradually increased, and at the 
end of a week the horse may be turned loose, or put to 



LYMPHANGITIS 123 

light work. At the end of the first four or five days, if 
the swelling is not receding satisfactorily the fomenta- 
tions and astringents are to be discontinued and a solu- 
tion of potassium dichromate is painted over the entire 
limb once or twice each day. In recurrent attacks inunc- 
tions of mercurial ointment once daily will dissipate the 
swelling more promptly than anything else. 

Cases of lymphangitis that prove obstinate under treat- 
ment can usually be brought to a satisfactory termination 
if iodid of potassium is administered in full dosage for 
several days. Abscesses which complicate an attack of 
lymphangitis are treated by incision and swabbing of 
their cavities with tincture of iodin. Abscess formation 
near the foot is best treated by soaking in antiseptic 
solutions, immersing the entire lower extremity in a pail 
full of the solution. Exuberant granulations in abscess 
cavities are removed by actual cauterization. 



124 SPECIAL EQUINE THERAPY 

EPIZOOTIC LYMPHANGITIS 

This term is slightly misleading in a veterinary sense. 
The veterinarian's comprehension of a lymphangitis is 
classically portrayed in the clinical picture of the idio- 
pathic form of lymphangitis discussed in the preceding 
chapter. 

Epizootic lymphangitis is confined chiefly to the super- 
ficial lym.phatics, and may make its appearance not only 
in an extremity, but in any portion of the body surface. 
It is caused by infection with a yeast mold. It is a very 
rare disease in this country, having been reported as pre- 
vailing in a few states only. Because of the similarity 
of some of its manifestations to cutaneous glanders, some 
of the cases reported may have been the latter, instead of 
the epizootic form of lymphangitis. 

Epizootic lymphangitis is a sub-acute and, at times, a 
chronic, affection. It is presumed to be transmissible. 
It is more probable, however, that a series of cases in a 
given district are the result of a common or regional 
etiologic factor. 

The symptoms are chiefly confined to the local mani- 
festations. In protracted attacks the affected animal may 
show some systematic disturbance, such as pyrexia, inap- 
petence, emaciation. The duration of an attack varies 
from one month in mild cases to seven or eight months in 
severe cases. The infection almost invariably occurs in 
an abrasion or superficial wound. As a result, healing of 
the wound is retarded, and the establishment of an ulcer- 
ated area takes place. A thickening immediately around 
this ulcer slowly forms, increasing in size to that of a 
goose egg in some cases. The swelling is not very painful, 
and from it, in many directions, are cord-like radiations. 
These are enlarged subcutaneous lymphatic vessels. The 
swelling at the original site of infection eventually breaks 



EPIZOOTIC LYMPHANGITIS 125 

down, emitting a rich yellow, tenacious pus. New swell- 
ings form along the course of the radiating lymphatic 
vessels. These also break down and discharge later. 
Healing may occur in some of these broken down areas. 
At times this healing is permanent, but in many instances 
new abscesses form on the site of the old ones. Those 
that heal leave little or no scar. In this manner the dis- 
ease may continue for months, either confining its activ- 
ity to a restricted area, or else involving a considerable 
portion of the integument. In very mild cases the mani- 
festations are not so pronounced, limiting themselves to 
pustular, pimply areas that resist treatment indefinitely. 
Epizootic lymphangitis must be differentiated from: 

1. Cutaneous glanders. 

2. Botryomycosis. 

The absence of other symptoms of glanders is estab- 
lished by clinical examination. If the result of such exam- 
ination is not decisive, malleinization is essential. The 
absence of the characteristic granules in the active area 
differentiates the condition from botryomycosis. 

Treatment. The treatment of this disease has not 
proved very satisfactory. Enucleation of affected lym- 
phatic glands and the thorough dissection of involved 
lymphatic vessels may terminate the condition, if per- 
formed early enough. Later cauterization and persist- 
ent antiseptic treatment, both internally and externally, 
must be used. All cases should be handled as an infec- 
tious disease, and proper precautionary measures should 
be taken to prevent the transmission of the disease to 
other horses. Infection is by direct contact only, from 
the use of currycombs, brushes, and other agents. 



126 SPECIAL EQUINE THERAPY 

FOOT SCAB 

Foot scab in horses is a localized form of mange caused 
by the Dermatocoptes communis, and is important for 
the practicing veterinarian because it must be differen- 
tiated from scratches. Foot scab is most prevalent during 
the winter months and affects the region that is commonly 
the seat of scratches, the posterior face and sides of the 
pastern region. 

Before any visible lesion is present there is considerable 
itching, which the horse manifests by stamping and gnaw- 
ing or licking the parts. Shortly after this the skin in 
the region desquamates and becomes scurfy and raw, fol- 
lowed by the formation of large crusts. The skin becomes 
thickened, and transverse wrinkles or folds are formed. 
Eventually these assume a tough, horny character and 
remain even after the disease has been eradicated. 

Treatment. In the itching stage one or two applica- 
tions of mercurial ointment, well rubbed in, will usually 
put an end to the trouble. Most cases, however, do not 
come to the veterinarian for treatment until actual skin 
lesions are present. These respond quite promptly to 
treatment with applications of coal-tar antiseptics or 
sulphur ointment. Transverse, horny wrinkles or folds 
can be slowly removed with a ten per cent ointment of 
salicylic acid, which should be applied daily. 

When it is not possible to treat the horse as above 
described, a complete cure can often be obtained by smear- 
ing the affected pastern regions liberally with pine tar. 
One application will accomplish the desired result in the 
early stages of the disease. When the disease has become 
chronic and the skin is marked with tough wrinkles and 
folds more careful treatment is required. Foot scab is 
transmissible through the agency of brushes, currycombs, 
cloths, ankleboots and attendants' hands. 



FOOT-ROT 127 

FOOT-ROT OF COLTS 

This disease has also been described as canker of the 
foot. As it differs markedly from true canker of the foot 
I prefer the name "foot-rot," which not only differen- 
tiates the condition from true canker of the foot but also 
describes the condition more accurately. 

Foot-rot affects colts usually from the first to the fourth 
year of life. I have seen only one case in the mature 
horse. While I have not been able to disprove the infec- 
tious nature of the condition, I do not believe that it is 
infectious. It appears nearly always in isolated cases 
and shows no tendency towards transmissibility. Appar- 
ently, it is a pathological process incident to colthood. 
Cases have been seen under sanitary as well as unsanitary 
stabling conditions. 

Symptoms. There is at first a slight "soreness" in 
movement of the affected foot. This may be any one of 
the four, although the disease shows a slight preference 
for the posterior extremities. Occasionally all four feet 
may be involved. About the time that attention is at- 
tracted to this soreness in movement, there is also noted a 
slight thickening in the region of the coronet. This 
thickening extends, in some cases, up to, and may even 
include, the ankle. If the swollen member is now care- 
fully examined it will be discovered that the sole of the 
foot is the seat of a degenerating process. There is an 
area, varying in size from an inch in diameter to two 
inches, in which the horn has degenerated into a black, 
mushy substance. If this area is curetted thoroughly 
an uneven layer of raw, easily-bleeding, granulating tis- 
sue is found below. The degenerating process slowly 
spreads, so that at the end of one or two months the entire 
sole of the foot may disappear, leaving the black, mushy 
substance already described, and under this an expanse of 



128 SPECIAL EQUINE THERAPY 

granulating soft tissue. Aside from the edematous swell- 
ing in the coronary and pastern regions no other 
symptoms are produced. 

If the condition is allowed to continue without appro- 
priate treatment a "drop-sole" usually results, making 
the horse unsound. 

Treatment. With a hoof knife and a curette the bot- 
tom of the foot must be thoroughly cleaned up, removing 
all degenerated parts of horn. The entire area is then 
to be wiped over a number of times with sponges of cotton 
so that it becomes perfectly dry. By means of a small 
brush or cotton swabs the whole of the diseased area is 
now thoroughly painted over with equal parts of formal- 
dehyd and glycerin. The colt is then to be confined in 
a dry stall. No bandages or dressings need to be applied. 

After three or four days the foot should be reexamined. 
If there are any new areas of degeneration these must be 
pared out, and the entire diseased section of the foot is 
then treated again with formaldehyd and glycerin. This 
performance is repeated every three or four days, and 
must be continued until there is a good growth of new 
horn beginning to appear. In mild cases one or two 
treatments may suffice, while in more extensive lesions 
seven or eight treatments may be required. 

An important feature in the handling of a case of foot- 
rot in a colt is that of keeping the foot as dry as possible. 
No washing of any kind must be employed and the colt 
should stand in a perfectly dry stall until the disease is 
under control. All the cleaning that is required must be 
done with the hoof knife, curette, and wads of dry cotton 
or oakum. "With unruly colts it may become a difficult 
matter to do this thoroughly unless they are first cast. If 
there are good reasons why the colt should not be cast 
in any individual case, the paring and cleaning part of 
tlie treatment can be omitted, and the formaldehyd and 



FOOT-ROT 129 

glycerin applied only. Recovery will, however, be consid- 
erably retarded under these conditions. The thorough 
removal of all of the diseased horn before the medicine 
is applied is a very important part of the treatment. 

In some cases that have existed untreated for a consid- 
erable period of time, some swelling may remain in the 
coronary and pastern regions after all other signs of foot- 
rot have disappeared. This swelling, while it appears to 
be nothing more than an edematous swelling, is, at times, 
very persistent and stubborn under treatment. A cooling 
astringent lotion should at first be prescribed and used 
for some time. If no improvement is shown after it has 
been used for ten days or two weeks, put the colt on a 
course of potassium iodid and apply tincture of iodin 
locally. The colt should have moderate exercise during 
the time it is being treated for the removal of this 
swelling. 



130 SPECIAL EQUINE THERAPY 

UMBILICAL HERNIA 

Umbilical hernia in colts should not be considered as a 
surgical condition before the sixth month. This form of 
rupture is amenable to medical treatment in probably 90 
per cent of all cases if treatment is begun not later than 
the second month of life. 

An umbilical hernia that gives no evidence of becoming 
reduced, or, on the other hand, that increases in size by 
the time the colt is two months old, should be treated. 
Umbilical hernia that decreases in size can be left alone 
until the colt nears the age of six months. Many cases of 
navel hernia disappear spontaneously before the sixth 
month. In all cases a cure should be attempted by medici- 
nal agents before surgical intervention is thought of. 
The risk with medical treatment is practically nil, and 
if the result should not be completely satisfactory, the 
colt is still a good subject for the surgical procedure. I 
repeat that, if treatment is begun not later than at two 
months of age, a cure results in 90 per cent of all cases. 
About one in ten will refuse to yield to such measures as 
I am about to outline, and appropriate surgical interfer- 
ence will be required for the correction of the abnormality 
in these. 

Treatment. Very small hernias will disappear with 
the use of ordinary blisters. The treatment that I have 
found the most cleanly, and that accomplishes uniformly 
satisfactory results with reasonable dispatch, consists of 
the application of fuming nitric acid. To make the appli- 
cation properly, the colt must be laid on his back. Before 
the acid is applied, a good sized area around the hernial 
enlargement, which area should not get nearer than one 
inch to the outer circumference of the enlargement, is 
liberally smeared with vaseline. Lard should not be 
used ; it is too light in body and does not remajn adherent 



UMBILICAL HERNIA 131 

long enough. The acid is then painted with moderate 
generosity over the enlargement itself. The colt is al- 
lowed to arise immediately. There is now and then a 
colt that will give slight evidence of pain from the appli- 
cation, but this is rare. 

Within a day there appears a diffuse swelling in and 
around the hernial enlargement. This remains for vari- 
able periods of time, usually a few weeks, and when it dis- 
appears it is noted that the hernia is also gone. There 
is usually a necrotic area in the skin where the acid has 
been applied. This area requires no attention, and as the 
location is always in a place where it can not be noticed, 
the slight scar that remains is no reason for objection to 
the treatment. One application is all that is required. 
Cases that do not yield to this application will not yield 
to any other form of medicinal treatment that I know of. 
This treatment is especially to be remembered because 
of its 

1. Ease of application. 3. Safety. 

2. Practicability. 4. Regularity of cure. 
Hernias that have not entirely disappeared when the 

swelling caused by the nitric acid is gone, should not be 
turned over to the surgeon with too much haste. Some 
that at first apparently have not been cured will yet 
slowly reduce in size during the following weeks. If, 
then, at the end of another two weeks no improvement 
is evident, surgical measures are in order. Such cases 
that still show some degree of hernia when the swelling 
from the acid treatment has disappeared will, if exam- 
ined, be found to contain in the bottom of the hernial 
sac a hardened disk of consolidated effusion. This should 
not be disturbed by manipulation, as on its endurance 
depends the beneficial action that may yet ensue. If no 
improvement has resulted when this disk has been en- 
tirely absorbed, none is to be expected later. 



132 SPECIAL EQUINE THERAPY 

PARALYSIS OF THE CAUDA EQUINA 

Injuries inflicted to horses in the region of the croup, 
that are of sufficient violence, at times result in hemor- 
rhages into the neural canal. At other times fractures 
of the caudal vertebrae inflict direct injury upon the ter- 
minal portion of the spinal cord. As a result of such 
injuries or hemorrhages there occurs a chronic intersti- 
tial inflammatory process, accompanied by the formation 
of variable amounts of fibrous tissue. Paralysis of the 
tail, and at times of the anal and vesical sphincters, fol- 
lows. The tail hangs loosely and flops about when the 
animal is trotted. There is total loss of motor power in 
the tail. In some cases this is only unilateral; the horse 
is able to switch flies on one side only. When there is 
also a paralysis of the anal and vesical sphincter the case 
is, indeed, a complicated one. The rectum becomes 
blocked with feces in its posterior portion, some of which 
drop out during movement of the horse at rapid gaits. 
The urine dribbles away constantly. There is also loss of 
sensation in a limited area in the region of the anus, 
which can be demonstrated by pricking with a sharp 
instrument. 

The prognosis is very unfavorable, as the condition 
becomes aggravated from month to month in most cases. 
As a result of involvement of the posterior portion of 
the rectum, there is rectal impaction, from which the ani- 
mal suffers almost constant distress and sometimes colicky 
pains. Cystitis may develop in a serious form from in- 
volvement of the bladder. At the end of a few months, 
or a year at most, the horse is useless. 

Treatment. In most cases this is of no avail. An occa- 
sional ease may become stationary at the end of a month 
or six weeks, and the paralytic symptoms may slowly 
clear up. Most cases, however, become progressively 



PARALYSIS OF THE CAUDA EQUINA 133 

worse in spite of anything that is done for them. If it 
is desired to keep the horse alive for any particular rea- 
son, the rectum must be emptied manually several times 
daily to prevent impaction and colic. To allay the irri- 
table condition in the bladder, salol, saw palmetto, bella- 
donna or stramonium should be administered. Treat- 
ment directed at the lesion in the cord should include 
potassium iodid. 

The horse must have nutritious food and good care in 
hygienic surroundings. In view of the fact that the whole 
trouble is the result of fibrous tissue formation in and 
around the cauda equina, it might be possible to accom- 
plish something with fibrolysin. I recommend its trial in 
this condition. Fibrolysin is made by Merck & Company, 
and its active principle is thiosynanim, which has a select- 
ive action on fibrous tissue and brings about its resorp- 
tion. I have already referred to results obtained with it 
in paraplegia following distemper in dogs in "Special 
Veterinary Therapy." While it would be desirable to 
bring the fibrolysin in direct contact with the lesion, this 
is not absolutely necessary. It can be given hypodermic- 
ally in any portion of the body. 



134 SPECIAL EQUINE THERAPY 

AGALACTIA IN MARES 

Absence of lacteal secretion, or agalactia, is a condition 
that occurs in mares with considerable frequency. It has 
at times been known to assume the proportions of an 
enzootic trouble, especially during recent years. The 
cause seems to lie in feed that is deficient in nitrogenous 
matter, the affection being most common during years 
in which oats are "light" and other grain feeds are of 
inferior quality. 

There occur two distinct varieties of this affection 
and their identification and recognition is important for 
reasons bearing on the prognosis. 

1. In the first form the mare "makes a bag," but the 
mammary development is checked at about the ninth 
month of pregnancy. In some cases the mammary glands 
decrease in size from this time on, and remain only 
slightly enlarged until parturition. The enlargement has 
a doughy, clammy feeling and, when the teat is stripped, 
its contents have the appearance of a blackish jelly. This 
form of agalactia in mares is never benefited by treat- 
ment, although at the next pregnancy the mammary 
glands may perform their functions in a perfectly normal 
manner. 

2. In the second form, the mammary glands show no 
sign of engorgement, or at least so little that it is barely 
noticeable, until a week or so before parturition. They 
then become slightly rounded; they occasionally show 
wax on the teat orifice, but contain no milk. If the teat 
is stripped a fluid is abstracted that has the appearance 
and consistency of very thin maple syrup. It is just a 
trifle sticky and has a light yellow tint. This form of the 
affection can be benefited by treatment, and at times the 
glands can be brought to normal function. For best 
results the treatment should begin before the end of the 



AGALACTIA 135 

gestation period, and should be brought to a climax on 
the date of parturition. In most eases the owner consults 
the veterinarian sufficiently early to make this possible. 
Treatment should be commenced a week or, better stiU, 
two weeks before parturition and should consist of : 

1. Dietary regulation and exercise. 

2. Local massage. 

3. Appropriate internal medication. 

1. The mare should be fed concentrated, nutritious 
feed. If good oats are not to be obtained, oatmeal must 
be fed. The amount of grain should be such as would 
be necessary were the mare performing hard work. Light 
exercise must be given with regularity. The best is driv- 
ing, going at a jog trot for periods not to exceed half an 
hour twice daily. 

2. Massage of the udder must be practiced. This, to 
have effect, must also be done regularly. The act should 
consist in quite vigorous manipulation of the glandular 
portion or body of the udder. Do not strip the teats. 
This udder massage should be given morning, noon and 
night. 

3. Internal treatment up to the day of parturition 
should consist of tonics and mild laxatives. A good com- 
bination is nux vomica, gentian, cascara sagrada, and 
licorice, in doses suitable to the weight and age of the 
mare. The amount of cascara sagrada should never ex- 
ceed one dram daily; in small doses this drug seems to 
have the action of a galactagogue. 

On the day of parturition the treatment is brought to 
a climax by the hypodermatic administration of pilocar- 
pin hydrochlorid, one grain, and strychnin, a half grain. 

Most mares that are affected in this manner will secrete 
enough milk to amply nourish their colts. Without 
treatment the lacteal fluid is entirely absent in every 
instance. In a few eases in which it was not possible to 



136 SPECIAL EQUINE THERAPY 

begin the treatment before the colt was born, I have been 
able to excite the secretion of milk in a mild degree by 
rapidly repeated doses of pilocarpin on the day of birth. 
When this treatment is resorted to, the colt in almost 
every instance develops a diarrhoea. This is usually of a 
mild type and responds to ordinary treatment. 

The occurrence of agalactia in brood mares, especially 
on small farms, is a veritable calamity. The veterinarian 
should warn his clients of the possibility of this occur- 
rence and should impress upon them the great impor- 
tance of early intervention in those cases of a curable 
form. 

In the first form described, I have never been able to 
accomplish anything with treatment. There seems to be 
in those cases not only an atony of the mammary glands, 
but also an aberration of function, and, although the 
glands sometimes respond to treatment by showing signs 
of renewed engorgement, the fluid which they secrete 
remains the same — a blackish jelly. In either form of 
the affection, the mare should not be discarded for breed- 
ing purposes; the milk flow may be normal at the next 
pregnancy. On the other hand, I have had two or three 
patients that developed agalactia in two successive 
pregnancies. 



STRANGLES 137 

STRANGLES 

Strangles can almost be said to be one of the commonest 
diseases of horses. Although this is true, and despite 
the fact that this volume is confined almost wholly to the 
discussion of rare diseases, strangles is given a place 
here for the reason that it very frequently has an influ- 
ence on the veterinarian's success in a community. The 
loss of a colt from strangles is a "black eye" that the 
veterinarian finds hard to cast off. 

Strangles is better known by its common name, dis- 
temper. It is an acute febrile disease resulting from 
infection with the streptococcus equi. Judging from the 
frequency with which horses suffer from this disease, 
one is led to think that this organism is universally dis- 
tributed and that it must of necessity be very tenacious 
of life. The disease seems to occur wherever horses are 
found, in all parts of the world. In itself a mild patho- 
logical process, this disease at times assumes a very grave 
character, not infrequently proving fatal because of the 
development of complications and the localization of pus 
foci in various parts of the body. 

Strangles, or distemper, is a disease that most fre- 
quently attacks young horses, from sucking age to ma- 
turity. Occasionally older horses become affected. After 
an incubation period of from three days to a week the 
horse refuses to respond to command as promptly as for- 
merly; the animal appears slightly depressed, or 
' ' dopey. ' ' The appetite lacks sharpness, and a little later 
the horse will not eat. There is now a discharge of 
muco-purulent matter from one or both nostrils; there 
may be a cough; and there is an enlargement of the 
submaxillary lymph glands. This enlargement is 
usually very painful under pressure. The temperature 
may be elevated only one or two degrees, or it may 



138 SPECIAL EQUINE THERAPY 

rise four or five degrees above normal in well-marked 
cases. 

After four or five days the appetite improves, the 
horse brightens up, and the glandular enlargement slowly 
disappears. 

This is about the clinical picture of strangles in prob- 
ably ninety per cent of all cases. It is safe to say that 
only a very small proportion of these cases ever come to 
the veterinarian 's attention. 

The common belief among horsemen seems to be that 
all colts are bound to have this disease sooner or later, and 
that usually it will take care of itself. This is prac- 
tically true in both instances, except that occasionally a 
case will become complicated; and there are not many 
other diseases that appear in such a multiplicity of vicious 
pathological manifestations as one of these complicated, 
or ''rotten" cases of distemper. 

It may so happen that a case of distemper will take 
an irregular, complicated course under the care of a vet- 
erinarian and the horse may die. This is a calamity in 
the career of a beginner in the practice of the science of 
veterinary medicine and surgery. It is something that 
many farmers, especially, can not comprehend — that a 
horse could die with distemper ! And nearly every time 
the veterinarian gets the blame. In the case of an old, 
established practitioner, this sort of an occurrence does 
not amount to very much. But with the recent graduate 
it frequently makes a big difference, often creates a seri- 
ous hindrance in the path of his successful career in the 
community. 

Strangles in an irregular form begins at times in the 
usual manner, while at other times it appears in a form 
that makes its recognition difficult. When strangles de- 
viates from its usual, mild course we see an aggravation 
of all symptoms. The temperature reaches higher bounds 



STRANGLES 139 

and persists indefinitely, at times dropping a degree or 
two and then suddenly rising again. The submaxillary 
enlargement goes over into abscess formation; the for- 
mation of abscess in the sub-lingual, retro-pharyngeal 
and other lymphatic glands follows. The parotid glands 
may next show enlargement, followed by pus formation. 
As a result of swelling which accompanies the formation 
of multiple abscesses in the laryngeal region and pharynx, 
there may follow serious dyspnea, so that tracheotomy 
may have to be performed. 

In a number of cases the trouble does not stop here. 
There may follow an inflammation of the lungs, or pleu- 
risy accompanied by empyema may develop. The facial 
sinuses may become the seat of a purulent process, be- 
coming filled with pus. In several cases I have seen 
abscess formation in various abdominal viscera. Abscess 
formation occasionally occurs in lymphatic glands in 
distant parts of the body, and skin lesions are not ex- 
ceptional. 

The course of the disease in an irregular form is very 
protracted, sometimes requiring two months' time before 
all manifestations of the disease have disappeared. Usu- 
ally the abscess formation goes forward in a successive 
m.anner, one forms after another; it is astounding in 
some cases to witness the progress. In the region of the 
head and neck I have seen as many as twenty individual 
abscesses. At the same time it is remarkable how well 
a colt will pass through, even a most severe case, at times. 
Permanent sequelae are quite rare. One attack of this 
disease is generally presumed to make the recovered horse 
permanently immune. 

Treatment. For the handling of strangles in any form, 
from the most ordinary attack to the most exaggerated, 
we have two means that alone can be relied upon. There 
are others, but the two that I am about to name are the 



140 SPECIAL EQUINE THERAPY 

sine quo non of strangles treatment. With these two 
alone we can accomplish all that is possible to accomplish, 
and we do this in a very direct manner. These two agents 
are: 

1. Bacterins. 

2. The abscess knife. 

If bacterins had absolutely no other ground for exist- 
ence, their effect in this disease alone would give them a 
high place in the catalogue of veterinary therapeutics. 
Either plain strepto-bacterins, or better still the mixed 
pus bacterins, are to be used in strangles. Every case 
of this disease that is serious enough to require any at- 
tention whatever should be given at least one full dose. 
Cases of greater severity should receive two doses forty- 
eight hours apart, and several doses thereafter every 
third day until the case is well under control. 

Abscesses that form should be lanced freely and 
promptly. On general principles the patient may be 
put on tonic treatment. Complications of a functional 
character are treated symptomatically as they arise. 

The early use of bacterin treatment has proved its 
worth as a preventive of complications and as a rapid 
control of existing lesions in hundreds of cases in my 
practice. So reliable have I found their action, and so 
unquestionable, that I would not hesitate to undertake 
the handling of strangles in any form with them alone. 



INFLUENZA 141 

INFLUENZA 

There is no one disease to which horses are subject 
that can present a greater variety of clinical pictures than 
this one. Influenza is essentially a contagious catarrhal 
fever. It is presumed to be due to infection with a 
microorganism of doubtful identity, and is presumably 
the equine type of "La Grippe." The characteristics 
of influenza are very similar in equine patients to those 
in human beings. They are fever, great depression, 
catarrhal changes in mucous and synovial membranes, 
and frequently grave complications such as pneumonia, 
and involvement of various organs in uncertain degree. 

It is a question whether there is such a thing as a 
typical attack of influenza. The disease rarely follows a 
typical course ; irregular developments are the rule rather 
than the exception. While affection of a distinct organ 
usually occurs in a typical form, it is only rarely that 
the same parts of the anatomy are invaded in a series of 
cases. When regular involvement of an organ, or a set 
of organs, occurs in an outbreak of influenza, the prac- 
titioner is very apt to be led astray in his diagnosis. The 
best example of this sort of an occurrence we have in 
the name "pink eye." This is nothing more than a 
panophthalmitis, now and then a mere conjunctivitis, 
being presented in the form of a localized influenza in- 
fection. Not many years ago ' ' pink eye ' ' was considered 
as a separate and distinct disease of horses. In like man- 
ner, we have witnessed outbreaks the cases of which were 
characterized by enteric symptoms, and in which the 
practitioner usually failed to see influenza infection. The 
most disastrous outbreak of this form of the disease 
occurred in the late '90 's. 

Quite regular involvement of other parts of the anat- 
omy have been observed in various epizootics of this dis- 



142 SPECIAL EQUINE THERAPY 

ease. Most commonly, however, influenza in equine pa- 
tients runs an irregular course, involving various organs 
and tissues in uncertain degree. 

In my opinion a typical case of influenza limits its 
manifestations to pathologic changes in mucous mem- 
branes. Whenever the case presents symptoms denoting 
involvement of an organic nature in other tissues, I be- 
lieve it is atypical and due to a mixed infection. Infec- 
tion with the virus of influenza gives, in my opinion, a 
typical attack of influenza characterized by high fever, 
depression, anorexia and catarrhal inflammation of mu- 
cous membranes. The addition of pus producing micro- 
organisms — various strepto- and staphylococci — making 
a mixed infection, gives us what are usually termed com- 
plications : in other words, atypical cases. This opinion 
is in great part substantiated by a fact with which many 
practitioners are well acquainted, namely, that many 
times these complications are more violent than the true 
influenza symptoms, and frequently manifest themselves 
when the symptoms of influenza proper are already under 
control. 

A division of influenza infections into catarrhal and 
pneumonic or pectoral sets, is not rational. A division 
can only be made on the basis of typical and atypical 
manifestations, classing all cases with symptoms that 
deviate from those of an acute, catarrhal inflamma- 
tion, and its recognized phenomena, as atypical. Thus 
we may have a typical enteric influenza or a typical 
pectoral influenza, or a typical influenza infection of 
any other organ or tissue. But the course of the 
infection in any organ or tissue can only be typical 
when the pathological invasion is true to type; that is, 
when the infection is not a mixed infection. Just as soon 
as the virus of influenza is reinforced by staphylo- or 
streptococcus infection in an organ or tissue, symptoms 



INFLUENZA 143 

are produced which are atypical of influenza, and the 
case is then to be classified, of course, as an atypical case. 

If we are ready to adopt this view and this method of 
classifying the disease, we must then admit that influenza, 
typical or true to type, is usually a very transient and 
benign affection. It is only those cases which are atyp- 
ical — in other words, those cases in which the addition 
of pus-producing organisms has occurred — that are seri- 
ous. From the practitioner's standpoint, this conclusion, 
based on the foregoing classification, will prove to be of 
merit, and of great assistance in the handling of both the 
typical and the atypical forms of this disease. Of course, 
as long as the identity of the infecting agent in influenza 
is in doubt, no classification from a bacteriological stand- 
point can be made with certainty. From a clinical stand- 
point, however, the foregoing classification is rational. 

Symptoms. Typical form. A well-marked infiuenza 
infection usually begins with a chill or rigor. The tem- 
perature rapidly ascends to from 104 degrees to 106 de- 
grees F. The horse gives evidence of great depression, 
appears "dopey" and listless. There is usually a muco- 
purulent nasal discharge and pertussis. The appetite is 
entirely lacking or at least indifferent. The visible mu- 
cous membranes are considerably injected and have 
nearly always a jaundiced cast. There is lachrymation 
and varying degrees of photophobia. The feces are 
coated with mucus ; the urine is scanty and high-colored. 
The pulse is irregular and increased in frequency. 

Depending upon the degree of involvement of tracheal 
and bronchial mucous membranes, there is a correspond- 
ing deviation from normal respiratory sounds and move- 
ments. Catarrhal pneumonia is not an unusual typical 
manifestation. 

All of the foregoing symptoms vary in individual cases 
from very mild exhibitions proceeding to a favorable ter- 



144 SPECIAL EQUINE THERAPY 

mination at the end of four or five days, to most violent 
presentations requiring several weeks to come to a favora- 
ble end ; or else terminating in various complications and 
sequelse, or even death. 

Atypical cases are inaugurated in a variety of phases. 
Some of them begin as typical cases, later becoming atyp- 
ical as a result of the invasion of a mixed infection. 
Others make their appearance known by the development 
of purely local lesions, such, for instance, as edema in 
certain parts of the anatomy, synovitis, tendinitis, or 
even lymphangitis. There may be manifestations of 
varying degrees of dermatitis, laminitis, or panophthal- 
mitis. Pleurisy with purulent exudate, resulting in 
empyema; pleuro-pneumonia with necrotic tendencies; 
suppurative hepatitis; parenchymatous nephritis; all of 
these have been known to develop in atypical influenza 
either primarily or secondarily. 

In the presence of influenza enzootics or epizootics the 
practitioner must suspect this disease as the excitant in 
every instance of abnormality that can not be referred to 
a recognizable cause. One attack of influenza does not 
confer permanent immunity. It is even doubtful whether 
a temporary immunity exists after recovery from an 
attack of this disease. 

Typical influenza must be differentiated from simple 
catarrhal fever, colds, etc. Atypical cases may occasion- 
ally be confused with distemper in young horses, stran- 
gles, and, under certain conditions, glanders in the acute 
form. The period of incubation in influenza varies from 
three to ten days. 

Treatment. Mild cases of the typical form in influenza 
require no special medication. Good warm quarters, 
proper ventilation, and tonic treatment bring these eases 
to a satisfactory end within four or five days. 

More severe cases of the typical variety are treated 



INFLUENZA 145 

symptomatically. In my practice every case of influenza 
is given a dose or two of mixed bacterins, the idea of this 
being to forestall the invasion of pus-producing micro- 
organisms. The results have always been highly satis- 
factory. Medicinal treatment varies with the symptoms 
presented, but is in the main of a supportive nature. 

As a routine treatment, no matter in what form the 
disease occurs, I find the administration of intestinal an- 
tiseptics of great benefit. Salol or the sulphocarbolates 
compound may be used for this purpose in suitable dosage 
for repetition two or three times daily. In atypical cases 
the treatment is also symptomatic. Depressants are to be 
avoided in all forms. As a routine form of treatment I 
would suggest mixed bacterins, intestinal antiseptics and 
tonics. Complications are to be met with appropriate 
treatment as they arise. The bacterins may be replaced 
by the anti-influenza serum in some cases — cases in which 
debility is marked. There is also on the market now a 
special influenza bacterin, composed of those streptococci 
which are usually found in atypical or complicated cases. 
This bacterin is also of value for purposes of prophylaxis. 

SequelcE. Influenza is frequently followed by after- 
effects of a permanent character as well as transient 
pathological effects. One of the most common after- 
effects is purpura hemorrhagica, although the occurrence 
of this sequel is a good deal less frequent under the bac- 
terin treatment. In the treatment of eases of purpura 
hemorrhagica that follow on an attack of influenza, the 
practitioner must endeavor, more than anything else, to 
avoid any depleting agents. Aim to do everything pos- 
sible towards building up the debilitated state of the pa- 
tient's system. Warmth, pure air, nutritious feed, tonics 
and good nursing are to be featured. Influenza is to be 
considered always as a very readily transmissible disease. 
Cases developing in stables among other horses should 



146 SPECIAL EQUINE THEEAPY 

immediately be isolated. Cases of this disease are pre- 
sumed to be contagious for variable periods of time even 
after all symptoms of the disease have disappeared. This 
period of time probably never exceeds ten days. 

New horses, especially green horses, added to the mem- 
bers of stables are always to be considered as infected. 
They should receive a prophylactic dose of anti-influenza 
serum or influenza bacterins, and isolated for a period of 
ten days. If the disease has not made its appearance at 
the end of this time the animal may be considered free 
from the infection. 



MENINGITIS 147 

INFECTIOUS CEREBROSPINAL MENINGITIS 

While there is no tangible evidence to show the specific- 
ity of any grade of inflammation in the coverings of 
the brain and spinal cord in Equidae, there is no doubt 
about the infectious character of certain types of this 
condition from a clinical standpoint. A type of cerebro- 
spinal meningitis has on occasions taken on an epizootic 
character among horses, and enzootic outbreaks of the 
disease are seen in various parts of the United States 
almost every year. By far the most cases occur in the 
spring and in the fall. Both young and aged horses are 
affected. 

The disease presents symptoms the severity of which 
coincides with the extent and gravity of the inflammation 
in the meninges and with the amount of effusion that 
occurs as a result of this inflamnaation. As both the 
degree of inflammation and the quantity of effusion are 
variable, so also do the symptoms vary in particular cases 
from violent, almost maniacal attacks to dull, mediocre 
or indifferent manifestations. 

In the most active form the disease begins with a high 
temperature in company with a rather slow, full pulse. 
There is from the beginning a certain degree of psychic 
bias. I mean that the horse shows some peculiarity of 
action, of countenance, of attitude, which can only be 
attributed to a brain and spinal cord lesion. There de- 
velop in rapid succession, sometimes simultaneously, dys- 
phagia, lack of coordination, ' ' staggers, ' ' delirium, decu- 
bitus and death. Opisthotonos prevails throughout the 
attack. Saliva drools from the mouth, the horse has dif- 
ficulty in maintaining a comfortable attitude; he may 
plunge violently about, faU, and die in convulsions. The 
onset of symptoms to the end in death may take not more 
than twenty-four hours. 



148 SPECIAL EQUINE THERAPY 

Cases of such viruleney are not so common as those in 
which the disease begins with a moderate rise in tem- 
perature. Some difficulty in swallowing is present; the 
facial expression is dull, vacant, stupid; the head hangs 
heavily or it is pressed firmly against a wall or other 
object. If the animal is made to move, the movements 
are made sub-consciously and without recognition. There 
are moments when the animal appears brighter, but these 
become less frequent and of shorter duration. At the end 
of two or three days the animal goes down, remaining in 
the recumbent position for variable lengths of time until 
recovery or death terminates the case. During the entire 
period of recumbency (which may last from three to fif- 
teen days) there are spells of delirium alternating with 
lucid periods. Before death occurs there is in most cases 
marked coma with subnormal temperature. 

Favorable cases begin to improve after a few days of 
semi-comatose periods; the horse recognizes voices, calls 
for feed, later rises to chest position and with assistance 
will rise. Dysphagia, lack of coordination, facial paraly- 
sis, paraphimosis and other troubles may remain indefi- 
nitely, as complications or sequelaB. 

Cases with violent symptoms must be differentiated 
from rabies. Anthrax must be considered in diagnosis 
of hyper-acute cases. Mild cases must be differentiated 
from simple meningism. The differential point here has 
been pointed out in the chapter on meningism. 

Treatment. I begin the treatment in every ease with 
fifteen grains barium chlorid intravenously. This pro- 
vokes rapid elimination of the intestinal contents and, if 
administered early enough in the attack, changes the 
entire aspect of even a serious case. In my hands the 
results from this handling have been very gratifying. 
The remainder of the treatment consists of alternate 
doses of Fowler's solution of arsenic and potassium iodid 



MENINGITIS 149 

in amounts varying according to the weight of the pa- 
tient. I give half an ounce of Fowler's solution and a 
dram of potassium iodid at each dose for a twelve-hun- 
dred-pound horse. Beginning with the Fowler's solu- 
tion, I have the attendant administer a dose of the iodid 
three hours later; again three hours later the arsenic 
solution, and so on every three hours from early morning 
to late at night, I keep this up until an ounce of the 
potassium iodid has been given ; then I continue Fowler 's 
solution alone every four or five hours. 

With this treatment I have had some remarkable results 
in this disease. I pay no attention to the patient's gen- 
eral condition, such as the appetite, temperature, and so 
on. Neither do I worry about the position of the patient ; 
if recumbent, I have him turned over every three or four 
hours. 

As a prophylactic measure, hexamethylenamine should 
be administered to other horses in the stable where a case 
exists. This drug can be relied upon to prevent the de- 
velopment of this disease if it is used before infection has 
occurred. From one to two drams should be given in a 
pail of water twice daily. 

As it is quite generally conceded that the infectious 
matter gains entrance to the body in feed or drinking 
water, both should be changed if possible. On general 
principles all cases of this disease should be handled as 
are those of transmissible diseases, even though doubt 
exists about the transmissibility. 

In exceptional instances the infecting agent seems to 
be so weak or inactive that the symptoms produced are 
very mild and diagnosis is difficult. In such cases, if 
one is not familiar with the vagaries of this condition, 
the cases are easily mistaken for influenza. Doubt can 
usually be dispelled, however, if the horse is excited. 
Cracking a whip and threatening the patient with it, wiU 



150 SPECIAL EQUINE THEEAPY 

nearly always make the animal show signs of the disease 
suspected, such as involuntary jerking of the limbs, 
twitching of the facial muscles, and at times opisthotonic 
position. The temperature in such cases is nearly always 
subnormal, sometimes as low as 97 degree F., reaching a 
degree or two above normal, after the disease is fully 
established. 

Some of these mild, doubtful cases later assume a very 
serious turn, running a prolonged sub-acute course. In 
many of them recovery is incomplete, lack of coordina- 
tion in the hind quarters remaining for variable periods 
of time. About twenty per cent of cases terminate fa- 
tally. The mortality in the hyper-acute cases is from 
sixty to eighty per cent. 

In the presence of cases of this disease the attending 
veterinarian is not infrequently questioned by the client 
in regard to the relationship between this disease in 
horses and infantile paralysis of children. While it was 
for a long time presumed that domestic animals could 
develop and transmit infantile paralysis to human beings, 
Simon Flexner has conclusively shown that the forms of 
paralytic meningitis that affect animals have no relation 
to similaB diseases in humans and, therefore, can not be 
transmitted to them. It has only recently occurred in 
my practice, however, that a case of infantile paralysis 
developed and caused the death of a child on a farm 
where, two weeks previously, I treated two well marked 
eases of cerebro-spinal meningitis in horses. No doubt 
this must be viewed as a coincidence only. 



ERYSIPELAS 151 



ERYSIPELAS 

This is an inflammatory skin disease which affects 
horses occasionally. It is caused by a streptococcus in- 
fection and is an acute, febrile disturbance. 

Symptoms. Erysipelas is frequently ushered in with 
a rigor. The temperature rises to 103 degrees P or even 
higher. Simultaneously with this there develops upon 
the infected region of the body a diffuse, painful thicken- 
ing. In two cases which occurred in our practice the 
infection was on the side of one hip. Within a few 
hours after the swelling develops there appear in the 
area numerous pea-sized vesicles. In another few hours 
these rupture and discharge a sticky, pale serum. The 
vesicles now coalesce and are soon covered with a dry, 
thin scab. In some cases there is great pruritis at this 
time. 

If the infection is on an extremity there is usually 
great lameness. In white horses the skin in the infected 
area is intensely reddened. The swelling and vesicle 
formation may spread progressively over a large area 
within a few days, or may limit its activity to the original 
area of infection. When the vesicles have burst and scab 
formation has taken place, the process of repair seems to 
begin immediately under the scab. In a few days the 
scab lifts off, leaving temporarily bare spots. Later 
these are again covered with hairs. 

Erysipelas is differentiated from other skin diseases 
by the force with which it makes its appearance. Its 
local manifestations appear in rapid order: 

1. Diffuse, painful swelling. 

2. Vesicle formation. 

3. Eupture of vesicles. 

4. Desquamation. 



152 SPECIAL EQUINE THERAPY 

Treatment. A purgative dose of aloes is given first, 
on general principles. Specific treatment in the form 
of streptobacterins gives fine results. The local mani- 
festations respond most promptly to painting with tinc- 
ture of chlorid of iron once or twice daily. This brings 
even severe eases to a prompt and satisfactory end. 

Erysipelas is one of the examples found in veterinary 
pathology that serves as a good illustration of the differ- 
ence existing in similar infections between animals and 
human beings. Clinically, erysipelas in animals does not 
compare with the same disease in human beings, and this 
is one of the chief reasons why erysipelatous infections 
in animals are usually not recognized as such clinically. 
The erysipelatous infection that is most commonly seen 
in animals is not nearly so grave in character as the 
usual erysipelatous infection occurring in human beings. 
I make this notation particularly for the reason that most 
text-books attempt to make an even comparison between 
the erysipelas of horses and the erysipelas of human 
beings. This tendency is the result of the all-too-common 
custom of permitting physicians to conduct the course in 
pathology in veterinary colleges. 



SEPTICEMIA 153 

SEPTICEMIA 

We shall take up this condition from its pathological 
standpoint first. The term septicemia literally means 
poisoned blood. The term is used in a rather broad 
sense, clinically. Speaking in a strictly pathological 
sense a septicemia would only include those conditions 
characterized by the presence of septic matter, or patho- 
genic bacteria, in the blood stream. Cases in which the 
morbid process is the result only of toxins in the blood 
stream can not, strictly speaking, be termed cases of 
septicemia. Furthermore, just at what moment or under 
what conditions, an ordinary infection of a wound ceases 
to be an ordinary infection and becomes a septicemia, is 
a doubtful point. From the practitioner's standpoint a 
septicemia is any serious or grave condition resulting 
from the infection of the organism with pathogenic bac- 
teria. When the infection is not severe enough to pro- 
duce marked systemic disturbance the practitioner is 
content to term it an ordinary infection. 

Clinically, for reasons bearing on the treatment of 
the condition, a septicemia needs to be differentiated 
chiefly from a pyemia. Pyemia makes its identity plain 
by the presence of localized pus collections, which are 
absent in cases of septicemia. A good definition for 
septicemia would read somewhat like this : Septicemia is 
an acute, febrile disturbance resulting from infection of 
the organism, either through a wound or otherwise, with 
pathogenic microorganisms. But, again from a clinical 
standpoint, the term septicemia is reserved almost always 
for systemic participation in wound infection of such a 
degree that it creates a clinical entity. In other words, 
whenever the systemic disturbance overshadows the local 
or traumatic lesion, the term septicemia finds applica- 
tion. The only differentiation to be made, and then from 



154 SPECIAL EQUINE THERAPY 

the viewpoint of treatment only, is from pyemia, and, 
under certain conditions, malignant edema. 

Symptoms. Septicemia appears in various degrees of 
severity, depending upon the virulency of the infecting 
agent and the resisting power of the animal infected. 
It develops early in the course of wound lesions in contra- 
distinction to pyemia which appears later and in a less 
precipitate manner. Septicemia is ushered in with a 
chill, which may, however, be mild in character and pass 
unnoticed. The temperature during the chill, or imme- 
diately thereafter, rises rapidly and may reach as high as 
107 degrees F. in a few hours. Temperatures of 105 de- 
grees F. and 106 degrees F. are ordinary in this condi- 
tion. The patient appears generally indisposed ; the res- 
pirations are increased, and the pulse exceeds its normal 
rate considerably. Feed is refused, and the patient gives 
other evidence of the gravity of its condition. The dis- 
charge from the wound has either ceased entirely, or it 
has assumed a thin, watery consistency. The immediate 
vicinity of the wound is the seat of a tense, firm, hot and 
painful swelling. Cord-like ramifications of this swelling 
may be seen following the course of the lymphatic vessels 
in some instances. In well marked cases this swelling 
rapidly increases in size and area, and in the course of a 
few hours it may involve an entire limb, or a great por- 
tion of the body. If the wound from which the infection 
developed is situated on one of the limbs, great lameness, 
entirely out of proportion to the extent of the trauma, 
develops. 

The swelling, when incised or tapped, emits no dis- 
charge other than a few drops of serum in the early 
stages. Later a rather free dripping of serum may fol- 
low when an incision is made. In exceptionally severe 
cases the patient may succumb within the course of seven 
or eight hours, collapsing suddenly and dying in a few 



SEPTICEMIA 155 

minutes. In less virulent infections the condition termi- 
nates in decubitus and death after a few days, violent 
delirium preceding the end in some cases, and pronounced 
coma in others. 

Cases that are promptly and judiciously treated recover 
after variable periods of time, depending upon the sever- 
ity of the infection, the treatment applied, and the recu- 
perative powers of the animal. In exceptional instances 
the infection is so virulent, and so rapidly and so grossly 
disseminated throughout the body, that the animal suc- 
cumbs before great swelling or other changes occur in 
the wound or its vicinity. These cases are rare. 

Differentiation. Pyemia: Pyemia is less tumultuous 
in its approach. It appears rather as a secondary develop- 
ment, often after the original seat of infection is under 
control. It is characterized by metastatic foci of pus. 
These vary from small abscesses to large pockets of puru- 
lent material. 

Malignant edema : The diagnostic feature of this con- 
dition is the characteristic odor, the gangrenous trend, 
and more especially the presence of gas in the tumefac- 
tion, evidenced by crepitation. 

Lymphangitis: The swelling in lymphangitis is more 
circumscribed, has a line of demarcation, and is of a 
doughy consistency. 

Treatment. The successful handling of a well devel- 
oped case of blood poisoning requires, in my opinion, the 
best professional judgment. The favorable progress of 
a given case is frequently interfered with by the most 
trivial circumstance in the method of treatment. It is 
my belief that many cases of septicemia terminate in 
death chiefly as the result of over-dosing with medicinal 
agencies. The practitioner too frequently allows his 
diagnosis of septicemia, "blood-poisoning," to take pos- 
session of his mental faculties to the extent of a veritable 



156 SPECIAL EQUINE THERAPY 

panic. He over-reaches in the attempt to save the life 
of his patient; he does too much. His treatment is too 
heroic, or it does not follow a sound line of therapeutics. 

What little reserve disease-resisting stamina the pa- 
tient has left, the veterinarian wipes out with his treat- 
ment. If there is one condition in which heroics do 
harm, it is in this one. Every move on the practitioner's 
part in the treatment of a case of septicemia should go no 
further than an effort at assistance. Do just enough to 
help the natural efforts inherent in the organism, and 
don't try to help too much. 

We can do all that should be done, all that it is possible 
to do in a really beneficial sense, with three things : 

1. Mixed bacterins; or anti-streptococcic serum, 

2. lodin, 

3. Nux vomica or strychnin. 

With this give me a lance, and I am ready to do battle 
with any case of septicemia resulting from wound 
infection. 

Begin the treatment, if the case is ordinary or mild, 
with a full dose of mixed bacterins. If the case is more 
than ordinarily severe, and you fear that bacterins will 
be too slow, use anti-streptococcic serum along with the 
bacterins. The serum will dilute and hold in abeyance 
the toxins in the blood stream until the bacterins can 
induce the elaboration of anti-bodies. There is no ques- 
tion in my mind in regard to the value of bacterins in 
acute infectious diseases. In fact, I have had much better 
results from bacterins in acute diseases than in chronic. 
I have used bacterins since 1906 (the first were "home- 
made") and, although my practice has probably not been 
so large as that of some veterinarians, I have used several 
thousand doses of them. I have so much faith in bac- 
terins and depend upon them to such an extent that I 
would find it a most difficult problem to practice without 



SEPTICEMIA 157 

them. I believe that the veterinarian who gets no results 
from baeterin treatment, or the one who disputes their 
value, has not learned the art of their successful appli- 
cation, and does not know enough about them to make a 
good judge of the matter 

In cases of septicemia I repeat the giving of bacterins 
on the third day; not three days later, but on the third 
day from the first dose. A third dose is then given three 
days later. 

As supportive treatment I rely wholly on nux vomica 
or strychnin. I give preference to the fluid extract of 
nux vomica and order it given in half-dram doses every 
three hours during the daytime. If for any reason oral 
administration is impracticable, it can be given per 
rectum with just as good effect, excepting for its beneficial 
action in creating an appetite. 

I have long ago discarded combinations of iron, quinin, 
and other hematinics. Their action is too slow and in 
nearly every instance accompanied by some disagreeable 
by-effect. Iron, for instance, constipates; quinin is a 
heart depressant when given in sufficient amount to be of 
benefit. 

For the local treatment of the seat of infection I can 
recommend tincture of iodin without reserve. But it 
must be used generously ; don 't be stingy with it. Paint 
the swelling and a considerable area beyond it freely 
with pure tincture of iodin twice daily. Literally soak 
the parts with it, and keep up this soaking twice every 
day until the case is terminated. 

If the wound is of such a nature that it does not drain 
well, make proper drainage, if possible, with the knife. 
For injecting the wound, in place of watery solutions of 
antiseptics, I highly recommend tincture of iodin, one 
part, in seven parts ether. This can be used without fear 
of doing damage in the most delicate tissues, and its 



158 SPECIAL EQUINE THERAPY 

action is very gratifying. The wound should not be mo- 
lested further than to provide drainage, and an appli- 
cation once or twice daily of the ether-iodin solution. 

Every practical means must be used to keep the pa- 
tient eating. The nux vomica, when given orally, plays 
no small part in this. The animal should have warm 
quarters and should not be subjected to unnecessary ex- 
citement. A good nurse is more than valuable. Under 
this treatment, with the addition of good nursing, even 
serious cases of septicemia are well on the road to recov- 
ery in a week. 

After-treatment, consisting of administering Fowler's 
solution of arsenic, or the elixir of iron, quinin and 
strychnin phosphate, may be indicated. 

During the time that the disease is active the patient 
must be confined in a single stall, and should not be 
moved out of this stall under any consideration until the 
disease has been conquered so far that the animal is 
again eating normally, and the swelling is receding. The 
animal may then be turned into a box stall. If no box 
stall is to be had the patient should be carefully led at 
the halter, walking not over half a block the first time 
out. The amount of exercise is then gradually to be in- 
creased. This is a very important point in the favorable 
termination of a case of this kind. 

In cases in which the immense swelling involves the 
under side of the abdomen and the sheath, a degree of 
paraphimosis may result. This rarely requires any spe- 
cial attention. The swelling and consequent protrusion 
of the organ does not remain long enough to be of any 
moment. As soon as the case has reached the stage in 
which exercise may be given, the swelling leaves, and 
the paraphimosis corrects itself. If the paraphimosis 
really becomes serious, the sheath may be scarified and 
the penis supported with appropriate bandages. 



SEPTICEMIA 159 

The baeterins that are used in the treatment of a ease 
of septicemia should contain not less than four billion 
killed staphylococci and one billion streptococci in each 
dose. All must be of equine source and must be polyva- 
lent or mixed. The injection of the baeterins must be 
made only subcutaneously, never intravenously, and then 
only in a region remote from the diseased area. Never 
inject them near the lesion. The anti-streptococcic serum 
may be given intravenously. The dose is from 20 to 40 
mils, daily. 



160 SPECIAL EQUINE THERAPY 

MALIGNANT EDEMA 

Horses seem to be more susceptible to this disease than 
other domesticated animals. It is an acute febrile dis- 
turbance characterized by the development of an edema- 
tous and gaseous swelling at the seat of inoculation. The 
infective organism is an anserobic bacillus, which is said 
to be universally present in the soil and in animal excre- 
ment. Despite the general distribution of the bacillus, 
the disease is comparatively rare. The infection develops 
most commonly in puncture wounds, contusions, or in- 
significant abrasions of the integument. Infection may 
also result from injuries to the mucous membrane of the 
mouth, nose, or eyes. The latter is rare. 

This disease runs a rapid and frequently fatal course. 
After the period of incubation has expired, an extensive 
swelling or edema develops at the seat of inoculation, 
within a few hours. It is usually a rather smooth swell- 
ing, blending gradually with the normal regions around 
it. At the same time the animal gives evidence of 
marked constitutional disturbance. The respirations are 
rapid; the pulse increased in frequency so that it may 
reach 60 or 70 beats per minute, and the temperature 
may rise to 106 degrees or 107 degrees F. in the course of 
the first few hours. 

"When the swelling at the point of infection has fully 
developed, it becomes emphysematous. When palpated it 
crepitates. This is due to gas formation in the subcu- 
taneous tissues as a result of the bacterial invasion and 
the establishment of necrotic processes. At the point in 
the swelling at which the disease is most active a gangre- 
nous area develops. This area is frequently darker in 
color than the remainder of the tumefied area, and, when 
cut into, this part of the tumefaction proves to be non- 
sensitive. At least, the affected animal gives no evidence 



MALIGNANT EDEMA 161 

of pain, from the knife stroke. In grave cases, or those 
which are not favorable, the tumefaction may spread over 
a considerable portion of the body. In certain sections 
of the South, malignant edema is frequently seen affecting 
the region of the parotid gland. The cases are nearly 
always fatal. 

Differentiation. The symptoms of malignant edema 
must be differentiated from subcutaneous emphysema 
following injuries, and from septicemia following an 
injury. Subcutaneous emphysema resulting from in- 
juries, and which is merely caused by suction created 
from movements of the thorax during breathing, is not 
accompanied by any systemic abnormalities. The tem- 
perature is normal, and the horse is not depressed or 
dejected. Usually, the wound in company with subcu- 
taneous emphysema is rather large and gaping. The 
wound in cases of malignant edema is nearly always a 
small puncture wound, and in most cases can not even be 
demonstrated. Septicemia resulting from wound infec- 
tion differs from malignant edema in the fact that crepi- 
tation is absent in the swelling of the former. Neither 
does septicemia show the gangrenous area at the active 
point in the swelling. 

Prognosis. This is unfavorable in probably fifty per 
cent of all cases, and in over ninety per cent of the serious 
cases. Death may come within four or five hours in 
some of the most severe cases. In moderate attacks it 
may come in a day or two, while mild cases recover after 
variable periods of time. Cases that live over forty-eight 
hours may be considered favorable after the lapse of such 
a period of time. 

Treatment. The treatment of malignant edema is not 
very satisfactory in results. Some practitioners have 
made reports of good results from the use of oxygen gas. 
A small oxygen tank, such as is used by some in the treat- 



162 SPECIAL EQUINE THERAPY 

ment of parturient paresis in cows, must be at hand. By- 
means of rubber tubing and a hypodermic needle the 
oxygen is forced freely into various parts of the tume- 
faction. 

Other practitioners claim good results from incising 
the active region of the swelling freely, and then packing 
it with gauze or wads of cotton previously saturated with 
hydrogen peroxid. All the cases that I saw were treated 
by simply cutting freely into the active area of the tume- 
faction and liberal irrigation with peroxid of hydrogen. 
All died. Cases reported as recovering are said to make 
a slow final recovery. Usually the gangrenous center of 
the tumefaction sloughs out. leaving a difficult wound to 
heal. 

In future cases of malignant edema in my practice I 
shall resort to treatment similar to that used in poisonous 
snake bite, namely, complete extirpation of the active 
area followed by the application of crystals or a saturated 
solution of permanganate of potassium. The internal 
treatment should consist of supportives. 



PURPURA HEMORRHAGICA 163 

PURPURA HEMORRHAGICA 

Purpura hemorrhagica is a pathological state of the 
animal organism characterized by the appearance of hem- 
orrhages into the subcutaneous and submucous tissues, 
in company with infiltration of these tissues with serum, 
and in some cases desquamation of parts of the integu- 
ment. It is said to be an infectious, but not a contagious, 
disease. At one time it was presumed to be contagious. 

The disease, from a veterinary standpoint, may almost 
be termed more correctly a sequel. Purpura hemor- 
rhagica in veterinary practice occurs almost always as 
a sequel to some other infectious, debilitating disease. 
The most common of these is influenza. Other cases 
follow an attack of strangles, or a case of distemper. A 
number of diseases seem to possess the faculty of so dis- 
arranging the animal organism that purpura hemor- 
rhagica supervenes. Just what this disarrangement of 
vital phenomena must amount to, is not easy to judge. 
Occasionally purpura hemorrhagica will follow an attack 
of influenza of ordinary grade, while another case that 
has been much more serious will not be followed by this 
sequel. In some instances only very mild or ordinary 
attacks of distemper have preceded the development of 
purpura hemorrhagica. To a certain extent this feature 
strengthens the belief that the disease is infectious, al- 
though no proof of a specific etiology has yet been pro- 
duced. On account of the usual infectious nature of the 
disease to which purpura hemorrhagica is a sequel, it 
becomes a most difficult matter to obtain satisfactory 
clinical evidence of the specificity of any organisms that 
might be isolated therefrom. Various streptococci have 
been blamed for this disease, but it has never been suc- 
cessfully transmitted by artificial inoculation with such 
cultures. 



164 SPECIAL EQUINE THERAPY 

Symptoms. Most cases do not come to the veterina- 
rian's attention until the disease has become quite well 
developed. The earliest sign is usually an edematous 
enlargement of the nose and face; occasionally the first 
swelling appears just in front of the trachea in its middle 
third. Cases which are not so often seen are those in 
which swellings appear distributed over the body in spots, 
somewhat resembling pronounced urticarial swellings. 
Simultaneously with the appearance of these edematous 
swellings, appear petechise on the visible mucous mem- 
branes, and hemorrhagic discharges are emitted from 
the natural openings. These discharges are thin and 
watery in consistency, and frequently have a rusty in- 
stead of a hemorrhagic tint. 

The edematous swellings become gradually more ex- 
tensive, so that at the end of three or four days they cover 
almost the entire animal. They are most marked in the 
extremities, the head, sides of the abdomen, and the pec- 
toral region. The surface of some of these swellings, as 
well as the flexion surfaces of such joints as the hock, 
carpus and pastern, exude the characteristic rusty or 
hemorrhagic fluid. 

The temperature in cases of purpura hemorrhagica is 
high early in the attack, reaching 106 degrees F. quite 
ordinarily. Later in the course of the disease, the tem- 
perature is what might be termed "fitful"; today it may 
be 104 degrees F. and tomorrow 102 degrees F., while the 
next day will record a temperature of 105 degrees F, or 
any number of variations. The general clinical attitude 
of the case rises and falls sympathetically with the tem- 
perature variations ; today the patient presents a favor- 
able aspect, tomorrow an unfavorable one. This could 
be explained most plausibly as a result of hemorrhages 
into internal organs of considerable importance, or of the 
out-pouring and absorption of exudates in the region of 



PURPURA HEMORRHAGICA 165 

physiologically important regions of the body. The pa- 
tients frequently have a good appetite throughout the 
entire course of the disease, although the great swelling 
of the lips may make prehension of food almost impos- 
sible. The edema may be so severe in the nasal region 
that breathing becomes difficult and suffocation may 
threaten. 

Affected animals maintain the standing position 
throughout the course of this disease. A terminal symp- 
tom in some cases is desquamation, occurring in patches. 

Complications. Complications are the rule rather than 
the exception in cases of purpura hemorrhagica. Why 
this should be is easy to understand when we recall that 
purpura, which is in itself a serious disease, frequently 
or almost always follows some other equally debilitating 
disease. The affected animal has not much resisting 
power left, and therefore easily becomes the subject of 
invasion by other destructive processes. 

Pleurisy, with hydrothorax, is a very common com- 
plication. Pneumonia and peritonitis are not uncommon. 
Laminitis may complicate a case of purpura hemor- 
rhagica. 

Other eases develop recurrent diarrhoeas ; and now and 
then attacks of acute indigestion may transform an other- 
wise favorable case into an unfavorable one. As a result 
of the pain due to acute indigestion, the animal is forced 
into recumbency and this is followed by death. Slough- 
ing of parts involved in some of the swellings may occur 
as a result of secondary infection in some cases. Acute 
iritis terminating in total or partial blindness is another 
complication that may develop. One or both eyes may 
be involved. 

Paraphimosis, constipation or actual impaction, and 
now and then intestinal flatulence, may aggravate a case 
of purpura hemorrhagica. 



166 SPECIAL EQUINE THERAPY 

In fact, the more experience one has with this disease, 
the less does he marvel at the appearance of complica- 
tions of any sort. One may expect anything in a case of 
purpura hemorrhagica. As has already been pointed out, 
the resisting power of the animal is at a low ebb. 

Differ eniiation. Purpura hemorrhagica is not easily 
confused with any other affection. In cases in which the 
swellings appear in spots it must be differentiated from 
urticaria. Examination of the visible membranes will 
disclose patechise in cases of purpura hemorrhagica, 
whereas in cases of urticaria these are absent. Violent 
pruritis common to urticaria is not exhibited in purpura 
hemorrhagica. The swellings of urticaria are transient, 
lasting at most a day or two. The purpural swelling 
becomes more pronounced during this time. 

Treatynent. My experience with purpura hemorrha- 
gica has shown it to be a self -limiting disease, the treat- 
ment of which is chiefly symptomatic. I have not been 
able to abort or shorten the duration of cases by the use 
of treatments that have been reported as doing this. In 
my experience I have found that it requires about one 
month for a well developed case of this disease to run its 
course to a favorable termination. Very mild cases may 
recover in half this time. 

I would place the rate of mortality at about forty per 
cent in the well marked cases, and at about twenty-five 
per cent in all cases. This death rate can not be said to 
be direct, because most of these animals die not from pur- 
pura hemorrhagica, but from complications incident 
thereto. 

Human patients have been recently reported promptly 
cured of purpura hemorrhagica by the intramuscular in- 
jection of large quantities of fresh blood. While I do 
not believe that this disease in human beings is the same 
as that which veterinarians find in their patients, I would 



PURPURA HEMORRHAGICA 167 

suggest that this form of treatment be tried in animals. 
Other physicians have recently reported fine results in 
the treatment of this disease in human beings from the 
use of emetin hydrochlorid. 

Dr. E. L. Quitman claims excellent results from potas- 
sium dichromate, orally, in three to six-grain doses every 
few hours, in purpura hemorrhagica of horses. He claims 
that the disease comes to a favorable termination in a 
much shorter time under this treatment. I have not 
been able to substantiate this, although I have not used 
this treatment in a sufficient number of cases to either 
recommend or condemn it. 

The best results that I have had were obtained with 
mixed bacterins. I treat my cases very much like I treat 
cases of septicemia. Bacterins and supportive medica- 
tion consisting of nux vomica and bitter tonics, some 
iron in the form of the tincture chlorid, and the handling 
of complications as they arise, will have as good results as 
other more troublesome and expensive procedures. 

Tracheotomy may be indicated in some cases. This 
should be resorted to at the earliest moment that it be- 
comes evident as a requirement. The tube must be kept 
perfectly clean, and may be removed and the wound al- 
lowed to heal as soon as the danger of suffocation has 
passed. 

The convalescence from purpura hemorrhagica is slow. 
Fowler's solution of arsenic, preparations of iron, quinin 
and strychnin, good feed and nursing, are important in 
after-treatment. 

Mild cases, promptly given bacterin treatment, may 
make a complete recovery and be ready for work in three 
weeks. Severe cases may require as long as two months 
before they are again in working condition. Mares in 
foal may pass through an attack of purpura hemorrhagica 
and give birth to healthy colts. In one instance that 



168 SPECIAL EQUINE THERAPY 

came to my notice a mare suffering from an exception- 
ally grave case of purpura hemorrhagica gave birth to a 
fine colt, in perfect health, while the attack was at its 
height. During the birth the mare assumed the recum- 
bent position, from which she was raised with difficulty, 
dying a day later. 



INFECTIOUS DYSENTERY 169 

ACUTE INFECTIOUS DYSENTERY 

In the northern half of the United States horses are 
the subjects of this disease. It is a hyper-acute, some- 
times rapidly fatal, form of diarrhoea occurring most 
frequently in young horses during the cold months of 
the year. While the etiology of this disease is as yet 
unknown, it is no doubt infectious in character, and is 
transmissible. It occurs in an enzootic form and may 
affect all the young horses in a series of stables. 

That it is not the result of errors in diet is easy to 
demonstrate. It occurs in stables widely separated and 
in which the feed and methods of feeding are not at all 
similar. It affects young horses indiscriminately in a 
stable or region, while the old horses fed on the same 
feed and under the same conditions are not affected. 
When a case develops in a stable in a young horse, other 
♦young horses in the stable can not be prevented from con- 
tracting the disease, although the method of feeding 
be changed immediately after the development and rec- 
ognition of the first case. The earliest cases in an out- 
break are usually the most severe. Towards the end 
of an enzootic series of cases, only mild attacks are seen. 

Symptoms. There are no premonitory signs that are 
noticeable. The horse may be attacked while idle or while 
in harness at work. Suddenly a diarrhoea begins. The 
evacuations are at first only a trifle more soft in con- 
sistency than normal, but an evacuation is followed by 
another every five or ten minutes. After three or four 
evacuations have occurred thus, the feces that are passed 
in following evacuations become more and more soft and 
watery. At the end of an hour the evacuations are merely 
water with a trace of feces in it. This liquid is passed 
every five or ten or, at most, every twenty, minutes, and 
spurts outward with considerable force. 



170 SPECIAL EQUINE THERAPY 

The horse shows no sign of pain, but soon, in two or 
three hours, signs of exhaustion appear. The patient 
perspires freely, the respirations are rapid and shallow, 
the pulse is almost imperceptible. If it can yet be counted 
by feeling over the course of an artery, the beats may 
register sixty to seventy per minute. 

The temperature usually stands near 103° P., although 
in some cases it is somewhat higher. If the case is not 
now taken in hand and given proper treatment, the 
animal soon succumbs. The facial expression becomes 
drowsy. Shifting of the weight from side to side follows ; 
there occur a few plunges or awkward straddling move- 
ments; the animal falls or clumsily lies down and death 
comes quickly. Autopsy shows an empty, slightly con- 
gested alimentary tract; nothing else. 

I have known cases of this disease to run their com- 
plete course, from first symptom to death, in so short 
a period of time as four hours. However, I have never 
known one to die, not even of the most severe form, when 
proper treatment was given during the early hours of the 
illness. Mild cases will recover without any treatment, 
but evidences of the disease remain for weeks in the 
form of inappetence, drowsiness, loss of weight, and in 
some instances edematous swellings affecting the limbs, 
head, etc. Even severe cases recover more completely 
under proper treatment than mild cases do if not treated. 
Furthermore, it is impossible to tell in the beginning of 
an attack how violent or severe the affection will become. 
The symptoms may improve spontaneously within a few 
hours; on the other hand another few hours may mark 
the death of the subject. It is therefore imperative that 
all cases be promptly treated. 

The diagnosis hinges on the history, namely, sudden 
and rapidly increasing diarrhoea without a sign of pre- 
vious illness, change of feed or other evident etiological 



INFECTIOUS DYSENTERY 171 

factor; and on the early exliaustion in the absence of 
signs of pain. The feces have no abnormal odor ; no blood 
or mucus accompanies the evacuated matter. The intes- 
tinal sounds heard by auscultation are not riotous, but 
have the sound of being compressed and wrung; very 
much such a sound as is emitted on crushing a bunch 
of grapes quickly in the hand. The sound approaches 
nearer to being a high-pitched, squashy crunching than 
any other description of it that I can give. 

Treatment. Experience with this disease under a 
variety of circumstances has demonstrated the fact that 
acids will check the course of an attack with almost mar- 
velous rapidity. Acetic acid gives the best results, be- 
sides being very cheap and easy to handle. The dilute 
acetic acid is given in from one- to three-ounce doses 
every twenty minutes until the evacuations occur with 
less force and regularity. As soon as this is apparent 
from a half to one ounce of tincture of opium is given in 
capsule. This completes the handling of the case. If 
the opium is given before the acetic acid has controlled 
the condition it has a tendency to cause flatulence and 
pain. 

If a case should come into the veterinarian's hands 
quite exhausted and apparently moribund, friction and 
warmth should be applied to the body, and half an ounce 
of spirits of camphor should be administered immedi- 
ately. Then begin at once with the acetic acid doses. 
The acetic acid can be given in capsules in mild cases. 
In the severe cases, give it with a dose syringe with an 
equal amount of warm water. 

I would warn the practitioner against giving an unfa- 
vorable prognosis in these cases even when the patient 
seems near collapse before the treatment is begun. With- 
hold prognosis until you have given a few doses of the 
acid. 



172 SPECIAL EQUINE THERAPY 

Mild cases treated should not be permitted to eat or 
drink anything for at least twelve hours. Well marked 
or serious cases should be made to fast for twenty-four 
hours after treatment. A course of tonic medicine is 
usually indicated as after-treatment in all cases. 

If a troublesome constipation should follow an attack 
of this disease, I would recommend that it be corrected 
by the use of either castor or linseed oil. Do not use salts. 

Cases treated as outlined above usually make a rapid 
and complete recovery. 



TETANUS 173 



TETANUS 

Because of the average practitioner's familiarity with 
this disease we will limit our discussion to a few inter- 
esting points regarding the pathological anatomy of 
tetanus and then consider the treatment. 

Tetanus is the result of an intoxication of the nervous 
elements with the toxin of the bacillus of Nicolaier. The 
bacillus is anaerobic, and the most favorable wounds for 
its activity are small wounds, deep punctures, and all 
traumata of such a character that will prevent free eon- 
tact of the exposed or injured tissue with the air. Large, 
open wounds are not favorable for the propagation of a 
tetanus infection. 

The period of incubation may be as short as forty- 
eight hours and as long as three weeks. An average 
can be reasonably placed at about eight days. This is 
influenced by the temperament of the animal, by the 
amount of infective matter, and the virulency thereof. 

Tetanus is one of the diseases in which the infecting 
organism remains at the site of inoculation; the symp- 
toms are the result of toxins which the bacillus elabo- 
rates. In tetanus these toxins travel along the nerve 
trunks, and no disturbing symptoms are occasioned until 
a sufficient quantity of toxins has been fixed in the brain 
cells. That this is not a mere theory has been shown by 
several investigators in the following manner : A horse 
is artificially inoculated with a virulent culture of tetanus 
bacilli, making the inoculation in the foot of one leg. 
A surgical division of all the regional nerve trunks 
is then made. The animal so treated will present no 
tetanus symptoms. Tetanus, for this reason, can not 
be strictly termed a toxemia. The exciting toxins 
do not travel in the blood stream. More properly speak- 



174 SPECIAL EQUINE THERAPY 

ing it is an intoxication of the nervous tissue of the 
body. 

An attack of tetanus does not confer a permanent 
immunity. Animals surviving an attack of this disease 
do acquire a certain degree of immunity, but the periods 
for which the immunity holds are uncertain in length. 
A second infection resulting in the development of a 
second attack of the disease has been reported in as short 
a time as two months after recovery from a primary 
attack. 

Tetanus can be prevented with almost positive cer- 
tainty by the proper use of prophylactic doses of anti- 
tetanic serum. A dose should be given as soon as possible 
after a wound of favorable character is inflicted. A sec- 
ond dose should be given eight days later. It is quite 
generally agreed that 500 units constitutes an ample pro- 
phylactic dose, if a similar dose is given eight days there- 
after. 

Tetanus appears in a more severe form in the Northern 
states than it does in the South. Cases occurring in the 
South nearly always terminate favorably, many of them 
making spontaneous recoveries. Tetanus in the colder 
climate of the North, especially in winter months, is a 
very grave condition, accompanied by a high death rate. 
The duration of an attack of tetanus is from four to six 
weeks. 

Treatment. There is no treatment for this disease 
which is accorded universal recognition. More than this, 
there is no known form of treatment which will give 
satisfactory results with any regularity. 

In giving credit for reported cures in this disease the 
practitioner should heavily discount results reported 
from the Southern states. Tetanus in the South, as has 
already been remarked, is a mild disease. I make this 
statement out of first-hand experience with this disease 



TETANUS 175 

in various parts of the South. Most of the reports of 
good results from anti-tetanic* serum come from the 
South. 

That tetanus can not be cured, nor even benefited, by 
the use of anti-tetanic serum was proved to me beyond all 
doubt while I was yet a student of veterinary medicine. 
I was serving at that time as an assistant to two veter- 
inarians in the city of Milwaukee. These gentlemen were 
in the employ of a live-stock insurance company that gave 
free veterinary services to the animals insured. The com- 
pany had at that time, as well as I can remember, more 
than 3,000 horses insured in Milwaukee, all of them in 
charge of the two veterinarians to whom I was assistant. 
No expense was ever thought of by these two gentlemen 
when it was a matter of saving the life of an insured 
horse; the insurance company paid the drug bills, and 
the watchword with them was, "go the limit." If ever 
anti-tetanic serum was given a thorough trial as a cura- 
tive agent, these two veterinarians gave it. I, myself, 
under their supervision, used more anti-tetanic serum in 
a single case of tetanus than I have used all told during 
the past twelve years, and more than I expect to use 
during the remainder of my career as a veterinary prac- 
titioner. Case after case was treated in this manner with 
not a shadow of benefit that could be attributed to the 
serum. True, some cases recovered; but not more rap- 
idly, nor with less trouble, than under the carbolic acid 
treatment which was in vogue at that time. And the cost 
of treatment with anti-tetanic serum was, therefore, and 
is today, entirely out of reasonable proportion to the 
benefit derived. 

The conclusion arrived at by the veterinarians referred 
to above was that any case of tetanus that recovers under 

*Anti-tetanic serum is the proper term. There is no tetanus 
anti-toxin used, or on the market. 



176 SPECIAL EQUINE THERAPY 

the serum treatment would also have recovered under 
other treatment. This conclusion was arrived at after a 
more thorough trial than could be generally accorded a 
remedy. The veterinarians were not hampered through 
considerations of expense; they had hospital facilities, 
ample assistance; in fact, everything was favorable for 
the serum, if it had a trace of merit. In the light of this 
and later experience with anti-tetanic serum, I can only 
condemn it as a curative agent. (As a prophylactic, I am 
just as positive that it has great value.) 

I use anti-tetanic serum now in my tetanus cases, but I 
use it in a different manner. I give two or three large 
doses of it in the beginning, from 2,000 to 3,500 units at 
a dose. I expect in this manner to get no results of a 
curative nature. What I have in view in administering 
the serum in this way is an effect that might be described 
as a "shock absorber." I expect this quantity of anti- 
tetanic serum to hold the toxins in abeyance, to dilute 
them, at least long enough to enable the patient to 
assemble all his bacteriolytic faculties. In plain words, 
I give him an opportunity tp ' ' catch up ' ' with the infec- 
tion. This is all that can be expected of anti-tetanic 
serum, all that can be claimed for it. And even this is 
only a theoretical merit; it is not apparent. 

It is a sorry fact, but a true one, that for almost our 
entire knowledge of the adaptability of various biologic 
agents, we must rely on the manufacturers of such agents. 
Only on this account do some of them continue to be 
exploited and used. Anti-tetanic serum for curative pur- 
poses is one. 

Other forms of treatment. The treatment of tetanus 
has in the past taken the form of fads. We have gone 
through courses of treatment with phenol, magnesium 
sulphate, tallianine, and, just now, we are in the grasp 
of the lobelin fad. All of these, as well as most of those 



TETANUS 177 

not named and including the Passiflora treatment rec- 
ommended by the author since 1905, are truly nothing but 
symptomatic treatments. In all truth and candor, from 
the clinical standpoint (which is always and only the 
viewpoint of the practitioner) , we must confess that what- 
ever we have of value in the treatment of tetanus is dis- 
tinctly of a symptomatic nature. "We try our best to 
control the disease and its symptoms; but we are not 
remarkably successful even in this. 

I will briefly discuss the most usual forms of treatment 
in vogue for this disease at the present time. 

Phenol treatment. Commonly termed the carbolic acid 
treatment. This form of treatment has survived longer 
than any of the other forms. It consists of the hypoder- 
mic injection of from two to five per cent solutions of 
carbolic acid in water. Sometimes a little glycerin is 
added. From thirty to sixty mil. are injected once a day, 
or every other day. Some veterinarians inject it at inter- 
vals of three days. Many cases recover with the use of 
this treatment, but so do they with the use of other treat- 
ments. The most noteworthy disadvantage in connection 
with this method is the formation of abscesses at many 
points of injection. The most noteworthy feature of an 
advantageous nature is its low cost and the ease of 
application. 

Magnesium sulphate treatment. This treatment is 
quite as ancient as the carbolic acid method, but it has 
recently been again brought out as a new treatment. 
Various amounts of a solution of magnesium sulphate are 
given by hypodermoclysis. No standard strength or 
quantity of solution has ever been established for veter- 
inary use. In my opinion this treatment has less ground 
for existence than any of the others. 

Loibelin sulphate treatment. The use of lobelin sul- 
phate in the treatment of tetanus is quite recent in origin. 



178 SPECIAL EQUINE THERAPY 

At first used only as an adjunctive agent with serum, it is 
at the present time being used by some practitioners as 
the entire treatment. Eecoveries have, of course, oc- 
curred and have been reported in veterinary journals. 
Its most ardent advocates up to this writing, however, 
have been the pharmaceutical houses that have it to sell. 
It is to be given in doses of one-twentieth to one-tenth 
grain, hypodermically, at least once each day until the 
symptoms are receding. 

Passiflora incarnata treatment. The use of fluid extract 
of Passiflora incarnata in the treatment of tetanus in 
horses is, so far as I know, original with Dr. Wendell 
A. Knight, formerly state veterinarian of Texas. 
While Dr. Knight's cases were of the mild type seen 
in the South, I can say from personal experience that 
equally good results are obtained with this agent in 
the more marked cases seen in Northern horses. I have 
used this treatment with more than ordinary success 
in cases of tetanus in extremely high altitudes during 
cold months of the year. I make mention of this because 
the disease is seen in its most active form in such 
regions. 

The one great disadvantage that this treatment has is 
in the fact that its administration is troublesome. It must 
be given with the dose syringe. One ounce of the fluid 
extract is given, just as it is, every three hours until the 
patient is free from excitement and marked spasms. 
After this it is given just often enough to keep up this 
effect. Tetanus cases treated with Passiflora recover 
more quickly and come out of the attack in better condi- 
tion than they do with any other form of treatment with 
which I am familiar. 

If I should be asked to state to the best of my profes- 
sional knowledge what I would do were I to outline a 
treatment for tetanus I would say, "Use heat and Pas- 



TETANUS 179 

siflora. " lu my opinion tetanus symptoms are milder 
in a Southern climate merely because of the climate. I do 
not believe it is so because the tetanus infection in the 
South is less virulent, or because Southern horses are not 
so susceptible to the action of its toxins. I believe that 
the climate is entirely responsible. In some parts of the 
South the natives take advantage of the beneficial effect 
of heat on tetanus symptoms. "When a horse develops 
tetanus he is at once confined in a small, almost air-tight 
enclosure having a tin or sheet-iron roof. The openings 
are draped with sacks or blankets to keep out the light. 
This is all the treatment the patient gets. But it is a real 
treatment, for when a high-noon Southern sun gets action 
on a tin roof, a Turkish bath establishment isn't in the 
running. And it is nothing out of the ordinary for a com- 
plete recovery to take place in so short a time as two or 
three weeks with no other treatment than heat, dark- 
ness, and quiet. 

I was on one occasion forced to use this treatment in 
one of my patients while I practiced in the South. The 
subject was a fat, chunky, 1,000-pound stallion. Each 
day at noon when I entered the little shed where he was 
confined, I feared the heat would overcome him. In less 
than three weeks he was again in harness, and his case 
had been rather a severe one, too. 

Veterinarians who contemplate the erection of a hos- 
pital should include in their plans a veritable ' ' dungeon ' ' 
stall that can be heated by steam until its temperature 
registers 100° F. or more. Tetanus cases only should be 
treated in such a stall. If in addition to this the patient 
is given the Passiflora treatment, the results, I am sure, 
will be most gratifying. 

Regarding the general handling of tetanus cases, it is 
only necessary to emphasize the enforcement of quiet and 
the provision of darkened quarters. Attendants should 



180 SPECIAL EQUINE THERAPY 

not be changed; the same attendant should administer 
all medicines, feed, water and give other care. If the site 
of infection is evident on some portion of the patient's 
body, it should be treated antiseptically if it can be done 
without unduly worrying and exciting the subject. I 
have heard of practitioners who cast a tetanus patient 
to treat the nail wound in the foot when they can yet find 
it. This shows about the same degree of common sense 
as is exhibited in the use of an operating table to save 
cocain. If it is impossible to treat the wound without 
aggravating the tetanus symptoms, leave the wound 
alone. Very little good results from local treatment of 
the case under any conditions, and unless the wound is in 
a region where it can be treated easily, I would advise 
non-interference . 

Much remains to be accomplished along the lines of 
a uniformly satisfactory treatment for this disease. The 
most that we can do with our present knowledge of this 
condition is to make the patient as comfortable as pos- 
sible; in other words, treat the symptoms to the best of 
our ability. 

Before closing the discussion of the treatment of this 
disease it can do no harm to repeat what has been said 
about the value of anti-tetanic serum as a prophylactic 
agent. Every practitioner of veterinary medicine and sur- 
gery should make it a routine practice to inject a pro- 
phylactic dose into all patients presenting injuries of a 
character favorable to tetanus infection. No treatment of 
a puncture wound is complete, either from the standpoint 
of judgment or law, unless it includes a prophylactic 
dose of anti-tetanic serum. For sure prophylaxis a second 
dose should be given eight days after the first one. In 
localities where the clientele does not readily submit to 
suggestions on the part of their veterinarians, the prac- 
titioner is in duty bound to inform a client of the risk 



ANTHRAX 181 

which goes with a puncture wound when anti-tetanic 
serum is not used. 



ANTHRAX 

Anthrax, called eharbon in the south, is a highly infec- 
tious disease, which frequently runs a hyper-acute course 
and has a very high mortality rate. It results from in- 
fection with the Bacillus anthracis, a relatively large 
micro-organism that is not very tenacious of life. 

Anthrax appears in various degrees of severity, from a 
hyper-acute form commonly termed apoplectiform an- 
thrax, to an ordinary, sub-acute, less fatal form. 

Anthrax makes its appearance most commonly in vari- 
ous parts of the country, in what are known as anthrax 
districts, where it usually assumes an enzootic character. 
These districts are almost always low-lying sections, such 
as river bottom land which is subject to annual inunda- 
tion. The Bacillus anthracis lives normally in the soil of 
such sections. Horses feeding on pasture are most fre- 
quently affected. On occasions the disease will, however, 
make its appearance even among stabled animals. 

The manner of infection is usually by way of the ali- 
mentary tract, resulting from the ingestion of infected 
fodder. The period of incubation is from forty-eight 
hours to ten days. Young animals are slightly more sus- 
ceptible than aged ones. 

Symptoms. Hyper-acute, or apopflectiform anthrax. 
The course of the disease in this form is usually so rapid 
and so violent that death may come within a few hours 
after the first sign of sickness. A horse which is appar- 
ently in perfect health suddenly stops feeding, shows a 
few moments of excitement and goes down in a few min- 
utes. The animal lies in a stupor, breathing stertorously. 
Sanguinous fluid issues from all the natural openings. 



182 SPECIAL EQUINE THERAPY 

and the visible membranes appear cyanotic. In various 
parts of the body edematous swellings begin to form rap- 
idly, convulsions set in, and death comes in the second 
or third hour. In some cases death occurs before any 
swellings are formed. The dead animal begins to bloat 
almost immediately after death. Rigor mortis does not 
become fully established in carcasses of animals dead 
from anthrax. 

Ordinary , or subacute forms. In this form the disease 
begins with a very high temperature which reaches 106° 
or 107° F. within an hour or two. The horse appears 
at first slightly excited, but soon shows symptoms of great 
depression. It stands fixedly in one spot until it either 
lies down or falls in an attempt to change its position. 
Labored respiration begins, the mucous membrances ap- 
pear almost cyanotic, and stupor rapidly develops. Ede- 
matous swellings now develop on various parts of the 
body ; under the neck along the trachea, flank region and 
parotid region. Colicky pains sometimes appear. There 
may be bloody scours, with protrusion of the rectal mem- 
branes ; the eyes, nostrils and the mouth discharge bloody 
secretions. The urinary secretion is usually hemorrhagic. 
Death comes in convulsions; the horse dies usually as 
though he were being strangled. The entire course of 
the disease in this form is from one to two days. Recovery 
is very rare. 

Differentiation. Anthrax is not easily mistaken for 
any other disease, but because of the high mortality rate 
it is not difficult to obtain material for proving the diag- 
nosis, and this should always be done. In the apoplectic 
form an ante-mortem diagnosis is hardly ever made be- 
cause the patient usually succumbs before the veterina- 
rian is on the ground. In making a postmortem exam- 
ination of carcasses in anthrax cases, every precaution 
should be taken by the veterinarian against infection. 



ANTHRAX 183 

No part of the carcass should be touched with the bare 
hands; heavy rubber gloves should always be used. 

The diagnosis can be made positive postmortem upon 
the following findings : 

1. Multiple hemorrhages into the connective tissue are 
seen immediately the integument is removed. 

2. The blood appears tarry-black in all the vessels and 
it does not coagulate. 

3. The edematous swellings, when cut into, are jelly- 
like in consistency. 

4. The lymphatic glands, when cut into, have a 
"strawberry" cast; they appear very much like the cut 
surface of a strawberry. 

5. The spleen is very much enlarged, and its paren- 
chjrma is easily broken down. 

6. Rigor mortis is only partial, or even entirely 
absent. 

In addition to these cardinal lesions there are hemor- 
rhagic areas in nearly every organ, serious infiltration 
is evident in nearly all tissues, and in some cases there 
are even necrotic areas. The diagnosis can be clinched 
by microscopic examination of blood smears; the large 
bacilli can be seen under low power, formed in short 
chains. 

Carcasses and all excreta of horses dead from anthrax 
should be burned. The infective agent exists in the 
alvine discharges and other excreta. 

Treatment. The treatment of anthrax in horses can 
be summed up in one word — prevention. Anthrax is 
nearly always fatal in horses. While cattle oftentimes 
recover from ordinary anthrax infections, horses nearly 
always die. The whole hope lies, therefore, in prevent- 
ive vaccination, a proceeding that is quite generally 
recognized. 

Recent developments along the line of curative treat- 



184 SPECIAL EQUINE THERAPY 

ment are those having to do with serums. Very promising 
results have been obtained so far by Eichorn and others, 
and the treatment of animals afflicted with anthrax will 
no doubt be made practically possible with immune serum 
in the near future. The present disadvantages, high cost, 
etc., will be overcome in some manner. 



RABIES 185 



RABIES 



This disease in nearly every instance runs a rapid and 
fatal course in the horse. It is characterized by symp- 
toms of great excitement, violent exhibitions, paralysis 
and death. Rabies is a disease that has been the subject 
of much controversy in regard to its true character in 
animals. Some pathologists of repute have even held 
that rabies, as a disease, does not exist in the lower ani- 
mals. The greatest confusion in arguments and theories 
along this line originates from the fact that an effort 
is usually made to make rabies conform to the manifesta- 
tions of hydrophobia as seen in human beings. An intel- 
ligent conception of rabies is only possible when all con- 
nections which it is presumed to have with hydrophobia 
are ignored from a clinical standpoint. 

It is now quite generally held that the bodies of Negri 
are the etiological factors in this disease. At first looked 
upon as coincidental to the pathological changes occur- 
ring in the brain as a result of the disease, they are now 
accepted as the true causative agents. 

The period of incubation in this disease is from one 
to ten weeks; an acceptable average can be placed in 
practice at three weeks. The period of incubation is 
shortest when the site of inoculation is on parts of the 
head. Belief is no longer held in exceptionally long 
periods of incubation. Cases of the disease which occur 
many months, or even years, after known exposure, are 
no doubt due to exposure or inoculation which was con- 
tracted later in an unknown manner. 

Horses are infected most frequently as a result of being 
bitten by dogs afflicted with the disease ; more rarely from 
bites of members of their own species. Relatively speak- 
ing, the horse is a very rare subject of this disease. The 
percentage of animals which develop rabies as a result of 



186 SPECIAL EQUINE THERAPY 

being bitten by other infected animals is comparatively 
small; I would place it at less than 25 per cent in the 
case of horses. (A capable veterinary pathologist of my 
acquaintance held that the infection is never transmitted 
in the bite of a horse. It was later possible for me to 
explode this theory in my own practice, to his entire 
satisfaction, ) 

Symptoms. Almost without exception rabies in the 
horse takes what is known as the furious form. Usually 
a history can be obtained that connects the development 
of the symptoms with a dog bite or, occasionally, a bite 
from a horse. Although many writers report itching in 
the region of the bite at the first symptom, I can not say 
that this always holds true. In some cases in my practice 
this early symptom was entirely absent. In my expe- 
rience the most constant and reliable early symptom has 
been a nervous, spasmodic retraction of the commissures 
of the mouth. Simultaneously with this, or very soon 
thereafter, there is ptosis of one eyelid, sometimes so 
slight that it is barely noticeable; but it is there. With 
this there is, in quite a few cases, a marked difference in 
the size of the pupils. I have been able to demonstrate 
one or all of these symptoms very early in the course of 
this disease in every instance coming to my attention. 

Soon after the manifestation of the foregoing symptoms 
the horse becomes restless; the ears are moving almost 
constantly, and pawing, neighing, defecation, urination 
and other acts are performed repeatedly in rapid suc- 
cession. There are contractions of the skin, which occur 
spasmodically, in various parts of the body. (In not a 
few cases there are symptoms at about this stage which 
resemble an attack of acute indigestion. This phase 
does not remain long, however; the colicky pains gradu- 
ally assume greater violence and end in maniacal out- 
bursts of ferocity.) If the horse is now offered a drink 



RABIES 187 

of water, it will be noticed that dysphagia has developed. 
"When this symptom becomes fully established there is 
very active salivation. The horse, in the general run of 
cases, requires from eight to twelve hours to reach this 
stage in the course of the disease. 

From this on there are symptoms which point quite 
plainly to the nature of the disease. Although the patient 
may have been normally very docile, he now assumes 
vicious tendencies. When approached, he attempts to 
nip, strike, or kick his attendant. This vicious tendency 
becomes rapidly more marked ; the animal plunges about, 
rearing, striking and biting. Towards the end the ani- 
mal often attacks its own flesh with its teeth, tearing 
out pieces of hide and muscle. Progressive paralysis now 
develops, the animal goes down and dies in convulsions. 
Death simulates that resulting from asphyxiation. The 
entire course of the disease usually consumes from 
twenty-four to forty-eight hours. While some writers 
have reported recoveries from this disease, I do not 
believe that recovery ever takes place. 

The treatment of rabies is impractical and would no 
doubt be useless, if attempted. Prophylactic treatment, 
according to the method of Pasteur, is a reliable prevent- 
ive if resorted to promptly after the horse has been ex- 
posed to infection. The veterinarian's whole efforts, when 
handling a case of rabies in a horse, are aimed at : 

1. Safeguarding other horses in the stable by so con- 
fining the patient that he will be practically harmless. 

2. Instructing attendants or owners, who may have 
been bitten, in the proper steps towards preventing the 
development of the disease in their own persons. 

3. The employment of the Pasteur treatment in horses 
that may have been injured by the patient. 

1. As soon as rabies is suspected the horse should be 
securely tied and, if possible, boxed in. This must be 



188 SPECIAL EQUINE THERAPY 

done with the expectation that the patient will become 
unmanageable within a few hours, and that great harm 
may result if the patient should run amuck. 

2. Persons that have been bitten should be urged to 
take the Pasteur treatment without delay. Therein lies 
their only hope of escaping a horrible death. While only 
about two per cent of those bitten by horses have (on 
record) developed hydrophobia, I advise against taking 
a chance. On this point the veterinarian is sometimes 
approached by persons who have accidentally come to 
some injury about the patient for variable periods of 
time before the animal developed symptoms. They desire 
to know whether they should submit to the Pasteur treat- 
ment. Persons who received wounds through some act 
of the horse in question, accidentally or with vicious in- 
tent on the part of the horse, ten days or less before the 
horse showed symptoms of rabies, should take the Pasteur 
treatment. Pathologists have found the saliva infectious 
eight days before symptoms were evident. 

3. If the rabid horse has attacked and actually bitten 
other horses in the same period of time or during the 
active stage of the disease, they should be isolated for 
sixty days. If no symptoms have developed by that time 
they may be presumed non-infected. If the bitten horse, 
or horses, should be of great value, the Pasteur treatment 
should be begun at once. 

Cases of rabies occurring in mares with foal at side are 
cause for isolating the colt for a period of sixty days, for 
the reason that the disease has been conveyed, in some 
cases, through the milk. The thorough disinfection of 
the stall in which the rabid animal was confined is impera- 
tive. While infection in any other manner than through 
a bite is almost unknown, it is possible that the disease 
could result from wounding of a part of the body with 
objects contaminated by saliva or other materials. 



TUBERCULOSIS 189 



TUBERCULOSIS 

Tuberculosis seems to be a very rare disease of horses. 
Whether this is true in fact, or whether it is merely appar- 
ent because it frequently goes unrecognized, is hard to 
say. Those cases that have been reported have been diag- 
nosed postmortem. The symptoms produced by the dis- 
ease do not seem to be very characteristic, and can easily 
be mistaken for the manifestations of glanders. 

Tuberculosis is suggested by such symptoms as chronic 
cough, nasal discharge, respiratory impediment resem- 
bling pulmonary emphysema, inanition and weakness. 
Enlargement of lymphatic glands, irregular temperature, 
and otherwise unexplainable functional disorders of a 
chronic type must also be considered as having a possible 
tuberculous origin. 

When the disease is suspected the animal should be 
subjected to a test with tuberculin. It is possible that 
the routine testing of horses with tuberculin, in a manner 
similar to such tests in cows, would show that the disease 
does occur with greater frequency than is generally con- 
ceded. If the horse does, on the other hand, possess such 
marked natural resistance to this disease as the scarcity 
of recorded cases would now indicate, the identity of the 
secret of this immunity should be investigated. Its rec- 
ognition might be of incalculable benefit in the prevention 
and treatment of tuberculosis in other species. 



190 SPECIAL EQUINE THEEAPY 



DOURINE 

Dourine, also called mal du coii, is a disease of horses 
that interests the practicing veterinarian chiefly from the 
standpoint of diagnosis, its treatment having been dis- 
countenanced by legal enactment. Dourine is probably 
the only true venereal disease of which horses are the 
subjects. It is characterized by local manifestations in 
the generative organs, with subsequent development of 
various degrees of paresis and disturbances of nervous 
function generally. 

The infection is transmitted almost entirely in coitus. 
The infecting agent is the Trypanosoma equiperdum. 
Trypanosomic infections are usually associated with hot 
climates, and the fact that dourine affects horses in cold 
climates also stamps it as one of the rare infections occur- 
ring in the United States. 

Because of the infrequent occurrence of this disease in 
the United States, there were, until the last occurrence 
in the Northwestern states, comparatively few veterina- 
rians in this country who were considered qualified to 
make a diagnosis of dourine clinically. I recall an in- 
stance that occurred in the Southwest, in the Mesilla 
Valley, in which even one of these qualified experts con- 
fused a botryomycotic process on the sheath and penis 
of a stallion with dourine. In another instance that 
occurred in my experience as assistant to the state veter- 
inarian of Texas, a series of experiments and postmortem 
examinations, which were made chiefly for the purpose 
of establishing a period of incubation for quarantine 
enactment, resulted in blank. One of the men in charge 
of the work was presumed to be an expert in the diagnosis 
and postmortem identification of the disease because of 
previous experience with it in other lands. From what I 



DOURINE 191 

saw happen at this meeting of experts, I came to lose all 
faith in them. 

Certain parties, whose identity must remain secret, 
made it an issue to fool the expert diagnostician from the 
very beginning, and he remained "fooled" throughout 
the experiments. Since that time, however, the disease 
has become better understood in most of its phases, espe- 
cially during the past four or five years; and its diag- 
nosis is frequently made, clinically, by many practition- 
ers. The period of incubation may be as short as one 
week. Under some conditions it may be six weeks. 

The symptoms as I give them here are as observed by 
me personally in two cases in the stallion and one case 
in the mare. 

Stallion 1. This was a pure-bred imported Percheron 
horse five years of age. The first symptom calling atten- 
tion to his case was frequent urination. This began two 
or three weeks after he had served the mare whose case is 
hereinafter reported. When the penis was protruded in 
the act of urination it was noted that the urethra was 
very prominent, appearing congested and flattened later- 
ally around the orifice. At the same time an edematous 
swelling began to appear in the sheath, which progressed 
quite rapidly and involved the true prepuce to such an 
extent that a degree of paraphimosis resulted after a few 
days. The swelling in the sheath was smooth and doughy 
and characteristically edematous. "Within a day or two 
after the paraphimosis developed the glans penis became 
the seat of a process simulating a moist eczema. 

On the anterior face of the glans, close to the urethral 
orifice, appeared what can best be described as a chancre, 
which broke down at the end of four or five days and 
formed a deep ulcer. Other similar chancres appeared 
on various parts of the penis during the course of the 
next week. Some of these healed over with rapidity. 



192 SPECIAL EQUINE THERAPY 

Where they had been, a white spot remained. Others 
refused to heal even under treatment, especially those 
near the urethral orifice. 

When the disease had been in existence for two or three 
weeks weeping areas appeared on the neck and in the 
crural region. These areas were from the size of a nickel 
to a dollar and appeared at first as a moist, weeping spot 
slightly elevated above the surrounding tissues. Within 
a few days this took the form of an ulcer, which healed 
kindly. The area was depigmented when healed. On 
various parts of the trunk, and also in the gluteal region, 
this stallion showed the typical whip-lash edema. This 
edema was migratory, appearing in different parts at 
Uimes. At the end of nearly two months the most marked 
of these early manifestations had disappeared. 

There now began to be shown a slight lack of coordina- 
tion in the posterior limbs, beginning at first very much 
like a case of ' ' shivering. ' ' Within another four or five 
weeks Ijhis had progressed to a real "wabble," so that 
the horse had difficulty in walking in a straight line. 

Stallion 2. This was a rather small Clydesdale grade, 
nearly ten years of age when he came to my attention. 
From the history given by the owner he had passed 
through the early manifestations in a typical manner. 
When I examined him he was so "wabbly" on his hind 
legs that in attempting to mount a mare he fell flat sev- 
eral times, rising each time with great difficulty. The 
glans was the seat of several depigmented areas, and the 
urethral orifice was deformed. A microscopic examina- 
tion of the semen showed only a few live spermatozoa. 

Mare 1. This mare was known to have had dourine 
for several years, having infected two different stallions 
belonging to the same owner. When I saw her she was 
in a pitiable state of emaciation. There was a ' ' gluey, ' ' 
mucilaginous collection in the lower commissure of the 



DOURINE 193 

vulva; the clitoris was very prominent and hypertro- 
phied. One side of the vulva and spotted areas on and 
near the clitoris were depigmented. Although very ema- 
ciated and lacking good coordination of movement, this 
mare appeared to be a nymphomaniac, accepting the 
service of the horse promiscuously. 

Some writers claim to have seen the development of the 
secondary symptoms — ^lack of coordination, etc. — without 
any marked local lesions primarily. 

Microscopic diagnosis should be called for in aU sus- 
pected cases of dourine. The parasites exist in the blood 
and secretions. They are said to disappear very rapidly 
after the death of the animal; postmortem microscopic 
diagnosis would therefore be unreliable. Antemortem, 
a blood smear is to be made, using R^manowskie 's stain. 

With the present system of eradication in use by the 
Bureau of Animal Industry against this disease, dourine 
will ultimately be completely eradicated. The system- 
atic inspection of imported horses of European origin 
will do much to prevent the bringing in of new eases. 
At the present time the disease seems to be well controlled 
in the United States. 



194 SPECIAL EQUINE THERAPY 



GLANDERS 

Glanders of horses is an infectious disease that appears 
most commonly as an insidious, chronic manifestation of 
lesions involving chiefly the respiratory tract. Less fre- 
quently it appears as a local disease in the skin and 
regional lymphatics, and still less frequently it appears 
in an acute form. It is a disease that is generally held to 
be incurable and against the treatment of which the vari- 
ous states of the Union have enacted regulations. 

Glanders, like tuberculosis, seems to be a disease that 
follows the trail of civilization; in fact, formerly many 
able veterinary pathologists considered glanders to be the 
equine form of a tubercular process. It is now a proved 
fact, however, that such is not the case, and that glanders 
is a distinct disease caused by an infection with the Bac- 
terium mallei. The disease is said to be unknown in 
regions where modern commerce and the interchange of 
horses among alien peoples are not actively indulged. 

Like dourine, glanders is important to the practicing 
veterinarian chiefly from the standpoint of diagnosis. As 
a result of active regulation and modified methods of 
eradication this disease is not nearly so prevalent as it 
was twenty, or even ten, years ago. In former times 
glanders frequently made its appearance among bodies of 
horses in a form that could almost be termed an epizootic. 
No doubt an occurrence of this sort was possible only 
because of lax quarantine and improper prophylactic 
measures. The universal recognition of the true infec- 
tious character, and the most common sources of contam- 
ination, is having the effect of an ultimate total eradi- 
cation of this disease. 

Symptoms. In discussing the symptoms of glanders 
it becomes necessary to classify the disease into three 



GLANDERS 195 

forms: (1) Chronic glanders; (2) Acute glanders; (3) 
Farcy, or glanderous lesions in the skin. 

1. Chronic glanders. This deserves to be discussed 
first because it is by far the most common form. Chronic 
glanders appears so insidiously that, when marked symp- 
toms really do become evident, the horse has already 
become generally vitiated by the infection. 

Probably the earliest objective sign is a nasal discharge. 
This may be uni- or bi-lateral, and is at first a thin, viscid 
fluid; later it becomes greenish, muco-purulent, and is 
occasionally streaked with blood. This streaking is the 
result of ulceration in the Schneiderian membrane. Some 
of these ulcers are visible to the eye near the anterior 
portion of the nasal septum, appearing as clear-cut, 
rounded, saucer-shaped depressions. When these heal, 
which they frequently do spontaneously, they leave a 
star-shaped, pearly cicatrix. 

The submaxillary lymphatic glands in chronic glanders 
are enlarged in a peculiar manner. The individual 
glandular lobules seem to become isolated from one an- 
other and then enlarged. This gives the mass the feeling 
of a layer of small peas. This glandular alteration and 
enlargement is not painful under pressure, and appears 
to be adherent to the overlying skin. 

As the case progresses, the nasal discharge becomes 
more plentiful. At times it may be malodorous, from 
necrotic processes in the nasal septum or in the sinuses 
of the head. The discharge now adheres to the nostril, 
making the nose appear filthy and smeary. As a result 
of confluent ulceration, there may occur perforation of 
the septum nasi. If the horse is now carefully examined 
there will be found an enlargement of nearly all the 
superficial lymphatic glands. In the lungs changes can 
be noted by auscultation and percussion. The horse 
becomes emaciated, has a general unthrifty appearance. 



196 SPECIAL EQUINE THERAPY 

and is finally unserviceable. Localized suppurative areas 
in the region of lymphatic glands may appear eventually. 

Acute glanders. Acute glanders is, luckily, very rare. 
Its diagnosis, clinically, presents difficulties. An attack 
of acute glanders does not differ materially from an 
attack of strangles in a serious form. Possibly the symp- 
toms in acute glanders are slightly more vicious from the 
very beginning. 

There is an occasional diagnostic feature, namely, the 
appearance of blood in the nasal discharge. A suspected 
case of strangles should be considered as glanders when- 
ever the nasal discharge is streaked with blood. This 
symptom does not occur in all cases of acute glanders, 
but when it does occur, it is quite reliable. 

Now and then a case of chronic glanders may become 
acute as a result of an overwhelming elaboration of toxins, 
to which the already lowered resisting power of the horse 
offers but little impediment. Such an occurrence is not 
so difficult to recognize as a primary acute attack of 
glanders. It is also well to suspect as acute glanders any 
malignant form of strangles, or what appears to be 
strangles, in horses that are over six years of age. 

Farcy, or localized glanders. When a glanders infec- 
tion confines its activity to a circumscribed area of super-^ 
ficial tissues, it is called farcy. The most frequent local- 
ization of a glanders infection is in a pelvic limb. The 
manifestation at first somewhat resembles ' ' grease-heel. ' ' 
There is fullness and thickening of the integument, and 
one or more areas of ulceration. These areas begin as a 
"bud" or node; they break down and remain as a crater- 
like area, of a mouse-eaten appearance. Some may heal 
over, while at the same time others appear; or subse- 
quently others make their appearance higher up on the 
limb, preferably in the seat of the popliteal lymphatics. 
Cord-like "runners" or swellings radiate from the ulcer 



GLANDERS 197 

in the subcutem. The limb eventually becomes a mass of 
ulcers and scars, becomes thickened and indurated. The 
horse succumbs as a result of septicemia, or the case 
becomes one of generalized glanders, which terminates 
fatally eventually. 

Diagnosis. The diagnosis of glanders can be made 
positive with the use of mallein, and while a clinical diag- 
nosis is frequently possible, mallein should always be 
used to verify the clinical diagnosis. The modus oper- 
andi of malleinization is practically identical with the 
application of tuberculin in tuberculin testing. Within 
the past few years the ophthalmic mallein test has become 
official, being used by the Bureau of Animal Industry in 
official tests of horses for glanders. 

The ophthalmic method is a great improvement on the 
subcutaneous method, being more simple and more rapid. 
It consists of depositing a quantity of mallein in the con- 
junctival sac by means of a camel-hair brush, or dropper. 
The presence of glanders in the horse gives a reaction in 
the form of varying degrees of conjunctivitis with puru- 
lent exudate or lachrymation. The eyes of horses that are 
free from glanders remain normal, or, at most, lachry- 
mate only slightly. 

Treatment. Glanders is never treated in the United 
States. The infected animal is to be destroyed in con- 
formity to the mandates of the legislative body in the 
state in which the case occurs. Most states indemnify 
the owner of the horse to a certain extent. 

Without a doubt the most important factor in the con- 
trol of glanders has been the compulsory mallein testing 
that has been imposed by most of the states on horses 
coming into their boundaries from other states. This, in 
effect, virtually gives one state a sort of check upon 
another. Another feature that has had great bearing on 
the control of the spread of glanders among horses is the 



198 SPECIAL EQUINE THERAPY 

increase in the number of graduate veterinarians and 
the decrease in the number of non-graduate practitioners 
in all states. 

It was not an uncommon occurrence for a non-graduate 
to treat a case of glanders under the supposition that it 
was nasal gleet. Cutaneous glanders or farcy was usually- 
treated as a case of chronic grease heel by most empirics. 
It is possible for glanders to be entirely eradicated in the 
course of time by the systematic use of mallein if, at the 
same time, empirical practice of veterinary medicine is 
prohibited. 



PART III 
POISONINGS 

Accidental poisoning of horses with drugs, chemicals 
and other substances occurs occasionally. In some rare 
instances intentional poisoning is the result of feuds and 
neighborhood quarrels. 

In the following pages is given a list of the most usual 
forms of poisoning, together with their symptoms and 
their treatment. The recognition of the effects of either 
an accidental or an intentional poisoning quite often 
depends upon the understanding which the veterinarian 
has of the more remote effects of the various poisons. 

The veterinarian must rely also to a great extent upon 
his powers of observation; some of the effects of some 
poisonous matters simulate the manifestations of certain 
diseases. The successful handling of these cases depends 
upon the veterinarian's alertness in detecting the true 
etiological factor ; a clue to the situation is at times quite 
apparent if the veterinarian is observant. On the other 
hand, the practitioner should never be rash in giving out 
his opinion that the patient has been poisoned. It is 
always best to add a proviso to such an opinion so that, 
should the diagnosis be in error, those concerned will not 
be unnecessarily aroused. A reckless diagnosis of inten- 
tional poisoning has, on a number of occasions, led to 
murder. 

The veterinarian is between two fires here. To pro- 
tect himself and his professional reputation, he must 
acquaint the client with the fact that his horse has been 
poisoned, and yet he must do it in such a manner that no 

199 



200 SPECIAL EQUINE THERAPY 

one will come to an untimely end as one result of the 
occurrence. 

On general principles, the diagnosis can always be 
made "ptomaine poisoning" until some one forces the 
issue. The treatment is strictly the veterinarian's own 
business and he will, of course, treat a case of arsenic 
poisoning as it should be treated, although to save his 
client an unpleasantness he may diagnose the case "pto- 
maine poisoning." A good veterinarian must also be a 
good man. 

Coal Oil or Kerosene Poisoning 

Poisoning of a horse with coal oil is a very common 
accident in regions where this agent is used by the laity 
for the treatment of colics. It is usually the result of 
giving an over-dose; on occasions a quart may be given 
a horse with the object of ' ' curing a colic. ' ' 

Symptoms. There is great depression. The pulse is 
irregular, thready, or it may even be imperceptible. The 
respirations are short and hurried, the extremities are 
cold, and the skin feels clammy. If a fold of skin is 
ridged up it returns very slowly to normal position. 
Temperature is subnormal. The marked odor of kero- 
sene removes any doubts about the diagnosis. 

Treatment. Give stimulants, such as aromatic spirits 
of ammonia, brandy or whiskey. Provide the patient 
with warm quarters and apply blankets. Employ some 
one to rub the extremities. Remain with the patient 
and administer to it until the respirations approach nor- 
mal and the pulse is improved. 

Death from kerosene poisoning comes very suddenly 
when a lethal dose has been given, and a lethal dose does 
not necessarily mean a very large dose if the horse hap- 
pens to have a heart lesion of some kind. 

Poisoning with kerosene frequently results in perma- 



POISONINGS 201 

nent sequelae, such as pulmonary emphysema, roaring, 
and vertigo. 

Carbolic Acid Poisoning 

Poisoning of horses with carbolic acid is usually acci- 
dental, by mistaking the acid for some harmless drug, 
placing carbolic acid in mis-labeled bottles, or misconcep- 
tion of the effects of the acid when given internally. 

Symptoms. The mouth shows white patches on the 
mucous membrane where the acid came in contact with 
it. Contracted pupils. The horse is listless, has mus- 
cular tremors, lack of coordination when forced to move. 
There is salivation, dyspnea, weak and rapid pulse, and 
usually a subnormal temperature. If the dose was lethal, 
collapse and deep coma precede death. The urine gives 
off the odor of the acid. 

Treatment. Alcohol is the antidote for this poison; 
give it freely. The best physiological antidote to be 
given in conjunction with the alcohol is atropin. If col- 
lapse threatens, use strychnia. Avoid giving anything 
oily. The direct chemical antidotes for the treatment of 
carbolic acid poisoning are the sulphates of magnesium 
and sodium. They form sulpho-carbolates. The best 
results are, however, gotten from alcohol. 

The three important items to remember in the treat- 
ment of carbolic acid poisoning are: 

1. Alcohol. 

2. Atropin. 

3. Strychnin. 

In districts where alcohol is not easy to obtain use 
magnesium or sodium sulphate. If neither alcohol nor 
one of these salts can be obtained, use vinegar. It is said 
to be almost as valuable as alcohol in this form of poison- 
ing. The alcohol has, however, the additional action of a 
stimulant, an action that is by no means superfluous here. 



202 SPECIAL EQUINE THERAPY 

Aconite Poisoning 

Poisoning of horses with aconite results from over- 
dosing by laymen in the treatment of colic, fevers, colds, 
or, in fact, in most any disease. Aconite has a very wide 
therapeutic field in the minds of laymen. Juggling with 
the official strength of the tincture of aconite, reducing 
its strength from thirty-five to ten per cent, may have 
resulted in some cases of poisoning by the giving of a 
new-strength dose of old thirty-five per cent tincture. 
The change made did more good than harm, however, and 
without question automatically prevented the poisoning 
of many horses by the use of this drug in the hands of 
laymen. I have known of instances where half-ounce 
doses of tincture of aconite were given repeatedly. 

Symptoms. Great weakness. Pulse slow and small. 
The horse seems to be blind. There is a cold, clammy 
sweat. Champing of the jaws, producing a foamy sali- 
vation, and "a peculiar clicking sound in the pharynx." 
The horse is bloated ; belches gas. The muscular weakness 
progresses if the dose has been lethal, and the animal 
goes down. Motor paralysis, loss of sensation in the 
skin, rapidly falling temperature, cardiac and respira- 
tory paralysis, and death. The horse remains conscious 
to the end. 

Treatment. Use the stomach tube and wash out the 
stomach. Give nitro-glycerin hypodermically. If this 
is not at hand, give freely of other rapidly acting stimu- 
lants. Keep the Jiorse warm, and avoid unnecessary 
movement. Treat the case as though you were momen- 
tarily expecting the horse to die from heart failure. 

Cocain Poisoning" 

The toxic effects of cocain at times become evident to 
an alarming degree after the injection of cocain solu- 
tions for local anesthetic effect. Other cases of poison- 



POISONINGS 203 

ing occur in a race track practice, where cocain is some- 
times administered for its exhilarating effect. 

Symptoms. Great excitement, restlessness, muscular 
twitching, free perspiration. Frequently simulates the 
early stages of azoturia, with violent muscular trembling. 
The pupil is widely dilated. Lethal doses result in de- 
lirium, and produce death suddenly by cardiac exhaus- 
tion. 

Treatment. Confine the horse in a quiet place, away 
from noise and excitement. The best effects are obtained 
from a full dose of chloral hydrate, given well diluted. 
If chloral hydrate is not to be obtained, give a full dose 
of morphin hypodermically. 

Arsenic Poisoning 

The toxic effect of arsenic results from the accidental 
eating of preparations intended for use as an insecticide ; 
from the administration by laymen of excessive doses of 
arsenic in the treatment of various diseases; from the 
eating of vegetation contaminated by fumes from ore 
smelters; and, lastly, as a result of malicious, willful 
poisoning. 

Arsenic is the favorite poison of the criminal, and 
horses are occasionally poisoned with it by cruel and re- 
vengeful persons. 

Symptoms. Arsenical intoxication, or chronic arsenic 
poisoning, is seen quite commonly in horses pastured 
near smelting works, where the grass becomes coated with 
arsenical compounds from the smoke and fumes. The 
horses so affected become emaciated, appear "mouse 
eaten," and drink great quantities of water. There is 
general soreness in motion, as a result of the development 
of neuritis; as a result of articular inflammations, there 
is great swelling in certain joints and marked lameness. 
Finally, necrosis occurs in osseous tissue. The teeth 



204 SPECIAL EQUINE THERAPY 

appear almost black in color, become loosened and may 
even fall out. Eventually complete paralysis results. 

Acute Arsenic Poisoning. Acute symptoms of arsenic 
poisoning usually take the form of a severe gastro-enteri- 
tis. The horse appears near collapse, trembles and suffers 
intensely. There is vomition and active purgation, occa- 
sionally blood is passed. The urine is also bloody when 
passed, but may be retained. Before death there is edema 
of dependent parts. The animal dies in coma. 

Treatment. In chronic arsenical poisoning the cause 
should be removed and the horse given a prolonged course 
of potassium iodid to hasten the elimination of arsenic. 

In acute poisoning the stomach tube should be used to 
evacuate the stomach. The direct chemical antidote is 
hydroxid of iron. To be effective this must be fresh, 
and given in from one to two-ounce doses every fifteen 
minutes. If this antidote is not available lime water 
should be given in generous potions. Oils and demul- 
cents should also be given. To relieve the intense pain 
which the animal suffers, large doses of morphin are to 
be given hypodermically. 

Acute arsenic poisoning in horses usually results fa- 
tally, unless the chemical antidote is administered early 
enough to prevent the absorption of a lethal quantity of 
the poison. Even then the case will frequently terminate 
in death from the effects of a violent gastro-enteritis. 

Poisoning with Mineral Acids 

Poisoning of horses with one of the mineral acids occurs 
now and then accidentally, as a result of mis-labeling the 
contents of bottles or mistakes in interpreting directions. 
The most common acids used are hydrochloric, sulphuric, 
and nitric acid. 

The symptoms of poisoning with any of these acids 
are soreness in the mouth, dyspnea, colicky pains. The 



POISONINGS 205 

dyspnea results from swelling in the pharynx as a result 
of burns from the action of the acid, and may be so seri- 
ous as to make tracheotomy necessary. 
The burns in the mouth are : 
Black from sulphuric acid; 
Tan or yellow from nitric acid; 
White from hydrochloric acid. 
Treatment of poisoning with these acids is by the use 
of alkalies, such as magnesium sulphate, sodium bicar- 
bonate and emulsions of soap. Water must not be given. 
If called early enough, use the stomach tube. Stimu- 
lants are to be given hypodermically to overcome 
depression. 

Gelsemium Poisoning 

In sections where gelsemium is used by the laity in 
the treatment of colics it is a common occurrence to be 
called to cases of poisoning with this drug. 

Symptoms. The horse appears as if asleep in a stand- 
ing position. If made to move he may fall. The pulse is 
very small and weak, occasionally skipping a beat. The 
pupils are dilated; the lower lip hangs loosely pendent. 
Respiration is labored. 

Treatment. Give large doses of aromatic spirits of 
ammonia or whisky. Strychnin may be given hypoder- 
mically in small doses. Use friction and slapping; 
blanket warmly. When the horse becomes somewhat 
aroused give gradually increasing walking exercises. 

Acute Lead Poisoning 

Acute lead poisoning occurs in horses now and then 
as a result of the accidental or vicious ingestion of paints. 
Because of the gravity of the symptoms produced and oc- 
casional fatal consequences the condition deserves men- 
tion in a work of this kind. 



206 SPECIAL EQUINE THERAPY 

Symptoms. Within a few hours after the substances 
have been ingested slight colicky pains develop. These 
are followed by a profuse diarrhoea, which is at first com- 
posed of fluid feces, later of clear liquid. The evacua- 
tions emit the odor of the particular lead-containing 
vehicle, usually oil. At the end of from twenty-four to 
forty-eight hours the animal appears in a state of collapse. 
The pulse is imperceptible, the integument cold and 
clammy. There are in some cases, crepitating areas 
under the skin, on various parts of the body. The horse 
now prefers to stand fixedly in one spot. When forced 
to move, the action resembles that of laminitis. 

If proper treatment is not promptly given, death comes 
at the end of two or three days after the lead-containing 
substance has been eaten. Before death occurs there are 
edematous areas in the extremities, and varying degrees 
of paralysis in some groups of muscles. The symptoms 
described appear in various modifications depending upon 
the amount of lead contained in the ingested substance. 

Treatment. If the animal comes into the veterina- 
rian's hands within a few hours after the poison has 
been eaten, the stomach tube may be used. From one to 
three ounces of magnesium sulphate is to be administered 
in watery solution every twenty or thirty minutes until a 
pound has been given. This is the most satisfactory an- 
tidote, chemically. Later a mixture of tincture of cap- 
sicum one dram, tincture of opium one ounce, is to be 
given to check the purgation. If necessary this dose may 
be repeated in an hour. The animal should be blanketed 
and quartered in a warm place. Exhaustion is counter- 
acted with alcohol, brandy, port wine, or strychnin. 

When the acute symptoms have been controlled, the 
animal should receive a course of iodid of potassium. 

Some of these cases become progressively worse and 
die in spite of anything that may be done. The diarrhoea 



POISONINGS 207 

is especially difficult to control at times. Some eases 
retain a paralysis of certain muscle groups indefinitely 
after making a good recovery from the acute symptoms. 
Animals that have ingested enough lead-containing 
substance to provoke marked symptoms are infirm and 
lack stamina for long periods of time after the symptoms 
of lead poisoning disappear. 



INDEX 



A Page 

Absence of lacteal secre- 
tion 134 

Aconite poisoning 202 

Acute infectious dysentery 169 
Acute infectious pharyn- 
gitis 24 

Acute yellow atrophy of 

the liver 83 

Agalactia in mare 134 

Anthrax 181 

Anti-tetanic serum 175 

Arsenic poisoning 203 

Atrophy of the liver 83 

Azolysin Ill 

Azoturia 101 

Azoturia, mechanical the- 
ory of 108 

B 

Bacillus anthracis 181 

Bacillus of Nicolaier 173 

Bacterins 140 

Big head 57 

Bile, re-absorption of . . . . 85 
Biliary secretion, repres- 
sion of 85 

Bones, myxoid degenera- 
tion of 21 

Brain, dropsy of the 65 

C 

Canker of the foot 127 

Carbolic acid poisoning. . 201 

209 



Page 

Catarrhal fever 141 

Cauda equina, paralysis 

of the 132 

Cerebro-spinal meningitis. 67 

Charbon 181 

Choke 35 

Choke, spasmodic 37 

Chronic polyarthritis 54 

Coal oil poisoning 200 

Coeain poisoning 202 

Colic, thrombotic 95 

Colts, foot rot of 127 

Commercial limitations of 

practice 7 

Contagious pustular stom- 
atitis 15 

Coughs 72 

Crural paralysis 118 

D 

Degeneration of bones 21 

Degeneration of liver cells 83 

Dermatocoptes communis. 126 

Diabetes insipidus 88 

Diabetes mellitus 90 

Diagnosis of poisoning. . . 200 

Diaphragm, spasm of the. 48 

Diarrhea, infectious 169 

Dilatation, esophageal. ... 40 

Diseases of the heart.... 99 

Distemper 137 

Dourine . . , 190 

Drop-sole 128 

Dropsy of the ventricles. . 65 



210 



INDEX 



Page 

Dummy 65 

Dysentery, acute infec- 
tious 169 

E 

Edema, malignant 160 

Edema of the glottis. .... 33 

Epidrosis 60 

Epizootic lymphangitis . . . 124 

Erysipelas 151 

Esophageal dilatation 40 

F 

Farcy 196 

Fibrolysin 133 

Foot, canker of the 127 

Foot rot of colts 127 

Foot scab 126 

6 

Geldings, pseudo-hysteria 

in 63 

Gelsemium poisoning 205 

Glanders 194 

Glottis, edema of the.... 33 

Guaiacol 34 

Guttural pouches, tym- 
pany of the 18 

H 

Heart, diseases of the .... 99 
Hemorrhage from the nose 13 

Hemorrhage, internal 61 

Hernia, umbilical 130 

Hydrocephalus, internal. . 65 
Hydrochloric acid poison- 
ing 204 

Hygroma of the withers. 42 

I 

Icterus 85 

Idiopathic lymphangitis.. 120 



Page 

Infantile paralysis 150 

Infectious cerebro - spinal 

meningitis 147 

Infectious pharyngitis 24 

Influenza 141 

Insipidus, diabetes 88 

Internal hemorrhage 61 

Internal hydrocephalus, 

permanent 65 

J 
Jaundice 85 

K 

Kerosene poisoning 200 

L 

Lacteal secretion, absence 

of 134 

La Grippe 141 

Laminitis 45 

Lead poisoning 205 

Leukemia, lymphatic 87 

Leukoma, myelogenous... 87 
Liver, acute yellow atro- 
phy of the 83 

Lobelin sulphate treat- 
ment of tetanus 177 

Lupinosis 92 

Lupinotoxin 92 

Lymphangitis 120 

Lymphangitis, epizootic . . 124 

Lymphatic leukemia 87 

M 

Magnesium sulphate 
treatment of tetanus... 177 

Mai du coit 190 

Malignant edema 160 

Malleinization 197 

Mange 59 



INDEX 



211 



Page 

Mares, agalactia in 134 

Mechanical theory of azo- 

turia 108 

Medication, system in. . . . 10 

Melanosis 51 

Mellitus, diabetes 90 

Meningism 67 

Meningitis, infectious .... 147 
Mesenteric arteries, ob- 
struction of 95 

Mineral acid poisoning... 204 

Monday morning sickness 120 

Myelogenous leukemia. . . 87 
Myxoid degeneration of 

bones 21 

N 

Negri bodies 185 

Nicolaier, bacillus of 173 

Nitric acid poisoning . 204 

Nose, hemmorrhage from 

the 13 

Obstruction of mesenteric 

arteries 95 

Ophthalmic mallein test. 197 

Osteomalacia 56 

Osteoporosis 56 

P 

Paralysis of the cauda 
equina 132 

Paralysis, senile pharyn- 
geal 31 

Paralysis, transient crural 118 

Passiflora incarnata treat- 
ment of tetanus 178 

Pharyngeal paralysis 31 

Pharyngitis, acute infec- 
tious 24 

Phenol treatment of te- 
tanus 177 



Page 

Pink eye 141 

Pneumonia 75 

Poisonings 199 

Poisoning, aconite 202 

Poisoning, acute lead 205 

Poisoning, arsenic 203 

Poisoning, carbolic acid. 201 

Poisoning, cocain 202 

Poisoning, diagnosis of . . . 200 

Poisoning, gelsemium . 205 

Poisoning, kerosene 200 

Poisoning with mineral 

acids 204 

Polyarthritis, chronic 54 

Practice, limitations of . . 7 
Pseudo-hysteria in the un- 

sexed male 63 

Purpura hemor- 

rhagica 145, 163 

Pyemia 155 

Q 

Quidding 31 

Rabies 185 

Ehinorrhagia 13 

S 

Scab, foot 126 

Scabies 59 

Sclerostoma 95 

Senile pharyngeal paral- 
ysis 31 

Septicemia 153 

Serum, anti-tetanic 175 

Spasm of the diaphragm. 48 

Spasmodic choke 37 

Stomatitis, contagious 

pustular 15 

Strangles , 137 

Streptococcus equi 137 



212 



INDEX 



Page 

Sugar disease 90 

Sulphurie acid poisoning. 204 
Sweat glands, abnormal 

activity of 60 

System in medication 10 



Tail, paralysis of the 132 

Test, ophthalmic mallein. 197 

Tetanus 173 

Tetanus, lobelin sulphate 

treatment of 177 

Tetanus, magnesium sul- 
phate treatment of.... 177 
Tetanus, Passiflora incar- 

nata treatment of 178 

Tetanus, phenol treatment 

of 177 

Thrombotic colic 95 

Thumps 48 

Transient crural paralysis 118 



Page 
Trypanosoma equiperdum. 190 

Tuberculosis 189 

Tympany of the guttural 
pouches 18 

U 

Umbilical hernia 130 



Ventricles, dropsy of the. 65 

Vertigo of young horses. . 70 
Veterinary practice from 

a commercial standpoint 7 

W 

Withers, hygroma of the 42 



Yellow atrophy of the 

liver 83 

Young horses, vertigo of. 70 



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